(180) Ergonomics of Various Modalities for Ear Surgery

Introduction: Surgical ergonomics has been an important topic to prevent muscle fatigue and workplace injury. This study evaluates the ergonomic differences of various modalities for performing otologic surgery.

Methods: This study is an observational study that examines the use of an endoscope, exoscope, microscope, and direct visualization. This study has included 9 surgeons in its study and only includes tympanoplasties and mastoidectomies. The outcome variable include the position of joints when using each modality in addition to the rapid upper limb assessment (RULA) score.

Results: 42 surgical pictures have been assessed so far. The exoscope demonstrates an average neck angle of 13.6 degrees while the endoscope demonstrates a similar neck angle of 15.8 degrees. The use of direct visualization has a clinically significant neck angle of 33.6 degrees which is not statistically significant on preliminary analysis. The endoscope demonstrates a similar RULA score to direct visualization (3.58 vs 3.63) while the exoscope demonstrates a slightly better RULA score (2.6). This was not statistically significant. All 3 modalities did not demonstrate statistically significant differences in upper arm, lower arm, or wrist angles.

Conclusions: Preliminary results point to a clinically significant difference in neck angle afforded by endoscope and exoscope use versus direct visualization. Other measures of body position are relatively similar. Consideration of the factors affecting higher RULA scores will enable more ergonomic use of these instruments.