Advancing Education, Research, and Quality of Care for the Head and Neck oncology patient.
Background: Otolaryngology surgeons operate in small areas of the head and neck, often requiring a significant amount of neck and back flexion. Prolonged surgical procedures often require sustained forward head posture, putting significant strain on the body – especially the neck and back. The prevalence of musculoskeletal strain in otolaryngologists ranges from 47% to 97%, with nearly 84% seeking medical treatment and up to 6% ceasing to operate. Ergonomic assessment tools, such as the Rapid Upper Limb Assessment (RULA), Neck Disability Index (NDI), and Oswestry Low Back Disability (OLBD) Questionnaire, are valuable for evaluating ergonomic risk in surgeons, especially for understanding the extent of work-related musculoskeletal disorders (WRMD) and its impact on daily quality of life.
Objective: This study aims to evaluate the prevalence and severity of work-related musculoskeletal problems among otolaryngology surgeons and to identify demographic and surgical task-related risk factors associated with physical strain.
Methods: Otolaryngology faculty and residents at University of Oklahoma Health Sciences Center meeting eligibility criteria participated in the preliminary study. Baseline data collection includes hand size, height, weight, gender, NDI, and OLBD. During surgeries, headlight or loupe use and weight are recorded pre-operatively with RULA conducted at 30-minute intervals intraoperatively. Postoperative measures consist of a surgical fatigue assessment which includes questions about case difficulty and maximal pain level. Preliminary data was collected over a 3-month period. We will analyze the data via t-tests, chi-squared tests, ANOVA, as well as assess demographic correlations.
Results: Preliminary data were collected from 16 otolaryngologists (5 faculty, 11 residents), including demographic characteristics (average age: 34.4 years, gender distribution: 69% male, 31% female, average height: 171.6 cm, average weight: 164.8 lb). The average self-reported maximal pain/discomfort immediately after 33 surgeries was 2.6 out of 10 compared to a baseline pain average of 1.4 out of 10. The surgeries rated “most difficult” had the highest average maximal pain/discomfort score of 4.5 out of 10. Although preliminary analysis showed no statistically significant difference in self-reported pain score and RULA score by surgery difficulty level, duration, and type of procedures, up to 54.5% of the intraoperative RULA measurements resulted in a medium to very high level of WRMD risk score (53.1% scored 5-6 or medium risk, 1.4% scored 7 or very high risk).
Conclusion: Initial findings highlight the prevalence of ergonomic challenges faced by otolaryngology surgeons, with early data suggesting that case difficulty may contribute to WRMD risk. Our data shows that a significant portion of surgeries are spent in ergonomic positions placing surgeons at high to severe risk needing intervention. By systematically measuring ergonomic strain among otolaryngologists, this study aims to provide insight into risk factors for WRMD and guide future interventions to reduce musculoskeletal harm in the surgical setting.