Ergonomic analysis of microlaryngoscopy

Statham, Melissa McCarty; Sukits, Alison L.; Redfern, Mark S.; Smith, Libby J.; Sok, John C.; Rosen, Clark A.

doi:10.1002/lary.20686

Cited by 45 publications

(63 citation statements)

References 10 publications

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“…The observed neck postures were within the 10–20°+ range measured by Statham et al (2010) during microlaryngoscopy. Included neck angles were 9–13° closer to neutral when subjects used video displays than when using microscopes (Table 1).…”

Section: Discussionsupporting

confidence: 53%

“…Observed shoulder flexion for all displays were within the 20–45° shoulder flexion range recommended for laryngeal microsurgery (Chen et al, 2012; Statham et al, 2010); however right shoulder flexion (defined in Table 1) was 9° higher on the Video3D than microscope (Table 1). The increase in shoulder flexion on the video displays was unexpected because 1) shoulder loads were predicted to increase with increasing shoulder angle, and 2) video displays were hypothesized to reduce posture constraints and allow subjects to choose comfortable postures that reduce musculoskeletal stresses.…”

Section: Discussionmentioning

confidence: 78%

“…Additional analysis was conducted on the neck, back, and shoulder postures, areas with high prevalence of musculoskeletal pain and disorders among surgeons who used optical magnification (Capone et al 2010; Sivak-Callcott et al 2011; Statham et al 2010). Postural shifts in the included neck angle (Table 1) were 3.22 times more frequent (p<0.05) on the Video3D than Micro3D (Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…Another study rated postures of laryngologists performing microsurgery on an operating microscope and measured rapid upper limb assessment (RULA) scores of 4–5, indicating poor posture and potential risk for injuries (McAtamney & Corlett 1993; Statham et al 2010). Posture constraints were postulated to be responsible for the significant association observed between microscope use greater than three hours per week and the prevalence of cervical and thoracic pain reported among 339 surveyed plastic surgeons (Capone et al 2010).…”

Section: Introductionmentioning

confidence: 99%

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Effect of alternative video displays on postures, perceived effort, and performance during microsurgery skill tasks

Green

Kasten

et al. 2016

Applied Ergonomics

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Physical work demands and posture constraint from operating microscopes may adversely affect microsurgeon health and performance. Alternative video displays were developed to reduce posture constraints. Their effects on postures, perceived efforts, and performance were compared with the microscope. Sixteen participants performed microsurgery skill tasks using both stereo and non-stereoscopic microscopes and video displays. Results showed that neck angles were 9–13° more neutral and shoulder flexion were 9–10° more elevated on the video display than the microscope. Time observed in neck extension was higher (30% vs. 17%) and neck movements were 3× more frequent on the video display than microscopes. Ratings of perceived efforts did not differ among displays, but usability ratings were better on the microscope than the video display. Performance times on the video displays were 66–110% slower than microscopes. Although postures improved, further research is needed to improve task performance on video displays.

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 78%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effect of alternative video displays on postures, perceived effort, and performance during microsurgery skill tasks

Green

Kasten

et al. 2016

Applied Ergonomics

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“…1). 4 This position may promote the early onset of fatigue during procedures, and may also decrease the ability of the surgeon to sustain steady control of the surgical instruments.…”

Section: Introductionmentioning

confidence: 99%

The head‐mounted microscope

et al. 2012

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Microsurgical equipment has greatly advanced since the inception of the microscope into the operating room. These advancements have allowed for superior surgical precision and better post-operative results. This study focuses on the use of the Leica HM500 head-mounted microscope for the operating phonosurgeon. The headmounted microscope has an optical zoom from 2Â to 9Â and provides a working distance from 300mm to 700mm. The headpiece, with its articulated eyepieces, adjusts easily to head shape and circumference, and offers a focus function, which is either automatic or manually controlled. We performed five microlaryngoscopic operations utilizing the head-mounted microscope with successful results. By creating a more ergonomically favorable operating posture, a surgeon may be able to obtain greater precision and success in phonomicrosurgery. Phonomicrosurgery requires the precise manipulation of long-handled cantilevered instruments through the narrow bore of a laryngoscope. The head-mounted microscope shortens the working distance compared with a stand microscope, thereby increasing arm stability, which may improve surgical precision. Also, the head-mounted design permits flexibility in head position, enabling operator comfort, and delaying musculoskeletal fatigue. A head-mounted microscope decreases the working distance and provides better ergonomics in laryngoscopic microsurgery. These advances provide the potential to promote precision in phonomicrosurgery.

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