Quantitative Ergonomic Comparison of Traditional Versus Endoscopic-Assisted Tonsillectomies: A Prospective Case-Control Study

Abstract

Five succinct key points: -Otolaryngologists are at high risk for ergonomic injury, particularly in the neck and cervical spine region. - There is a need to use validated ergonomic assessment tools to quantify the amount of risk in specific otolaryngology procedures and identify alternative methods to decrease that risk. -The physical positioning of the senior author was studied using the RULA score during two different operative approaches to tonsillectomy: one using an endoscope and one using direct visualization without the aid of an endoscope. - The RULA score for the traditional, non-endoscopic approach was 5, with a Neck, Trunk, and Leg Score of 6 and a Wrist/Arm score of 1, demonstrating a high risk and suggesting a need for further investigation and change. The RULA score for the endoscopic-assisted approach was 3, with a Neck, Trunk, and Leg score of 4 and a Wrist/Arm score of 1. -An endoscopic-assisted approach to tonsillectomy allowed for a lower RULA score than traditional tonsillectomy. This study suggests that an endoscopic approach may decrease the potential for musculoskeletal strain and reduce occupational-related pain and injury seen in practicing otolaryngologists.