Cervical Ergonomics in Head and Neck Endocrine Surgery: A Quantitative Assessment of Approaches.
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| Title: | Cervical Ergonomics in Head and Neck Endocrine Surgery: A Quantitative Assessment of Approaches. |
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| Authors: | Wei O; Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Seo S; Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Frazier KM; Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Plitt MA; Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.; Department of Otolaryngology-Head and Neck Surgery, Advocate Health Care, Chicago, Illinois, USA., Joo HH; Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Russell JO; Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.; Department of Otolaryngology-Head and Neck Surgery, Russell Center for Endocrine Health, Columbia, Maryland, USA., Galaiya D; Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. |
| Source: | Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [Otolaryngol Head Neck Surg] 2025 Oct; Vol. 173 (4), pp. 859-866. Date of Electronic Publication: 2025 Jul 31. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Wiley Country of Publication: England NLM ID: 8508176 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-6817 (Electronic) Linking ISSN: 01945998 NLM ISO Abbreviation: Otolaryngol Head Neck Surg Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2023- : [Oxford] : Wiley Original Publication: [Rochester, Minn.] : The Academy, [c1981- |
| MeSH Terms: | Ergonomics* , Neck* , Endocrine Surgical Procedures*/methods, Humans ; Cross-Sectional Studies ; Female |
| Abstract: | Objective: To quantitatively assess the intraoperative cervical ergonomics of head and neck endocrine surgery and compare differences between surgical approaches. Study Design: Cross-sectional assessment. Setting: Operating rooms of an academic tertiary care center. Methods: Intraoperative neck angles of otolaryngology attendings, fellows, and residents were recorded during head and neck endocrine surgeries. Two position sensors were affixed to the surgeon's midline between the scapulae and on the posterior scalp and calibrated at the beginning of each case. Raw quaternion data were analyzed to calculate neck angles during periods of active surgery. Neck flexion greater than 20 degrees and any degree of extension are defined as high-risk by the Rapid Upper Limb Assessment, a validated ergonomics risk tool. Results: Fifteen surgeries (nine transcervical, six transoral) were recorded between five surgeons. Average time spent in active surgery was 58.5 minutes for the transcervical approach and 64.1 minutes for transoral. Percentage of time spent in high-risk neck angles was significantly higher for transcervical than transoral cases (80% [95% CI: 72%-88%] of active operating time vs 42% [95% CI: 31%-60%], P = .0001). Surgeons in transcervical cases spent more time in neck extension than surgeons in transoral cases (36% [95% CI: 19%-43%] vs 12% [95% CI: 3%-23%], P = .04). Transcervical cases resulted in neck movement across a wider range of angles compared to transoral cases, with a standard deviation of 20 versus 12 degrees (P = .02). Conclusion: The transoral approach is favorable to the transcervical approach with respect to cervical ergonomics for head and neck endocrine surgeons. (© 2025 American Academy of Otolaryngology–Head and Neck Surgery Foundation.) |
| References: | Bolduc‐Bégin J, Prince F, Christopoulos A, Ayad T. Work‐related musculoskeletal symptoms amongst otolaryngologists and head and neck surgeons in Canada. Eur Arch Otrhinolaryngol. 2018;275(1):261‐267. doi:10.1007/s00405-017-4787-1. Ryan MT, Montgomery EA, Fryer J, et al. Ergonomics in otolaryngology: a systematic review and meta‐analysis. Laryngoscope. 2023;133(3):467‐475. doi:10.1002/lary.30216. Cavanagh J, Brake M, Kearns D, Hong P. Work environment discomfort and injury: an ergonomic survey study of the American Society of Pediatric Otolaryngology members. Am J Otolaryngol. 2012;33(4):441‐446. doi:10.1016/j.amjoto.2011.10.022. Hobbs CGL. Prevalence of back and neck pain amongst ENT consultants: national survey. J Laryngol Otol. 2004;118(5):395‐396; author reply 395. doi:10.1258/002221504323086679. Wong K, Grundfast KM, Levi JR. Assessing work‐related musculoskeletal symptoms among otolaryngology residents. Am J Otolaryngol. 2017;38(2):213‐217. doi:10.1016/j.amjoto.2017.01.013. Kelly N, Mousset M, Althubaiti A, Agarwal R, Onwuka A, Chiang T. Using the craniovertebral angle to quantify intraoperative ergonomic risk. Otolaryngol Head Neck Surg. 2022;167(4):664‐668. doi:10.1177/01945998211068726. Rodman C, Kelly N, Niermeyer W, et al. Quantitative assessment of surgical ergonomics in otolaryngology. Otolaryngol Head Neck Surg. 2020;163(6):1186‐1193. doi:10.1177/0194599820932851. Yang L, Wang T, Weidner TK, Madura JA, Morrow MM, Hallbeck MS. Intraoperative musculoskeletal discomfort and risk for surgeons during open and laparoscopic surgery. Surg Endosc. 2021;35(11):6335‐6343. doi:10.1007/s00464-020-08085-3. Leung KL, Segal RM, Bernstein JD, Orosco RK, Reid CM. Surgical ergonomics: assessment of surgeon posture and impact of training device during otolaryngology procedures. Laryngoscope Investig Otolaryngol. 2022;7(5):1351‐1359. doi:10.1002/lio2.901. Joo H, Lin Z, Yesantharao L, et al. Intraoperative neck angles in endoscopic and microscopic otologic surgeries. Otolaryngol Head Neck Surg. 2023;168(6):1494‐1501. doi:10.1002/ohn.226. Lin ME, Zhou S, Kakeheta S, Ito T, Shibata SB. Ergonomics of various modalities for ear surgery. OTO Open. 2024;8(3):e162. doi:10.1002/oto2.162. Rimmer J, Amin M, Fokkens WJ, Lund VJ. Endoscopic sinus surgery and musculoskeletal symptoms. Rhinology. 2016;54(2):105‐110. doi:10.4193/Rhino15.217. Dorion D, Darveau S. Do micropauses prevent surgeon's fatigue and loss of accuracy associated with prolonged surgery? An experimental prospective study. Ann Surg. 2013;257(2):256‐259. doi:10.1097/SLA.0b013e31825efe87. Russell JO, Razavi CR, Shaear M, et al. Transoral thyroidectomy: safety and outcomes of 200 consecutive North American cases. World J Surg. 2021;45(3):774‐781. doi:10.1007/s00268-020-05874-8. Anuwong A. Transoral endoscopic thyroidectomy vestibular approach: a series of the first 60 human cases. World J Surg. 2016;40(3):491‐497. doi:10.1007/s00268-015-3320-1. Arora A, Swords C, Garas G, et al. The perception of scar cosmesis following thyroid and parathyroid surgery: a prospective cohort study. Int J Surg. 2016;25:38‐43. doi:10.1016/j.ijsu.2015.11.021. Chen LW, Assadi N, Hefetz‐Kirshenbaum L, et al. Preferences for thyroidectomy technique: comparing traditional and transoral approaches. Head Neck. 2021;43(6):1747‐1758. doi:10.1002/hed.26627. Razavi CR, Khadem MGA, Fondong A, et al. Early outcomes in transoral vestibular thyroidectomy: robotic versus endoscopic techniques. Head Neck. 2018;40(10):2246‐2253. doi:10.1002/hed.25323. Russell JO, Razavi CR, Garstka ME, et al. Remote‐access thyroidectomy: a multi‐institutional North American experience with transaxillary, robotic facelift, and transoral endoscopic vestibular approaches. J Am Coll Surg. 2019;228(4):516‐522. doi:10.1016/j.jamcollsurg.2018.12.005. Grogan RH, Suh I, Chomsky‐Higgins K, et al. Patient eligibility for transoral endocrine surgery procedures in the United States. JAMA Netw Open. 2019;2(5):e194829. doi:10.1001/jamanetworkopen.2019.4829. Anuwong A, Sasanakietkul T, Jitpratoom P, et al. Transoral endoscopic thyroidectomy vestibular approach (TOETVA): indications, techniques and results. Surg Endosc. 2018;32(1):456‐465. doi:10.1007/s00464-017-5705-8. Tae K, Ji YB, Song CM, Park JS, Park JH, Kim DS. Safety and efficacy of transoral robotic and endoscopic thyroidectomy: the first 100 cases. Head Neck. 2020;42(2):321‐329. doi:10.1002/hed.25999. LPMS‐B2 series: 9‐axis inertial measurement unit/AHRS with Bluetooth Classic and BLE connectivity. https://www.lp-research.com/products/inertial-measurement-units-imu/lpms-b2/. McAtamney L, Nigel Corlett E. RULA: a survey method for the investigation of work‐related upper limb disorders. Appl Ergon. 1993;24(2):91‐99. doi:10.1016/0003-6870(93)90080-s. Meltzer AJ, Hallbeck MS, Morrow MM, et al. Measuring ergonomic risk in operating surgeons by using wearable technology. JAMA Surg. 2020;155(5):444‐446. doi:10.1001/jamasurg.2019.6384. Dabholkar T, Dabholkar YG, Yardi S, Sethi J. An objective ergonomic risk assessment of surgeons in real time while performing endoscopic sinus surgery. Indian J Otolaryngol Head Neck Surg. 2020;72(3):342‐349. doi:10.1007/s12070-020-01840-x. Lim AK, Ryu J, Yoon HM, Yang HC, Kim S. Ergonomic effects of medical augmented reality glasses in video‐assisted surgery. Surg Endosc. 2022;36(2):988‐998. doi:10.1007/s00464-021-08363-8. Lee J, Kang SW, Jung JJ, et al. Multicenter study of robotic thyroidectomy: short‐term postoperative outcomes and surgeon ergonomic considerations. Ann Surg Oncol. 2011;18(9):2538‐2547. doi:10.1245/s10434-011-1628-0. Elzomor A, Tunkel A, Lee E, et al. Intraoperative stretching microbreaks reduce surgery‐related musculoskeletal pain in otolaryngologists. Am J Otolaryngol. 2022;43(6):103594. doi:10.1016/j.amjoto.2022.103594. Cerier E, Hu A, Goldring A, Rho M, Kulkarni SA. Ergonomics workshop improves musculoskeletal symptoms in general surgery residents. J Surg Res. 2022;280:567‐574. doi:10.1016/j.jss.2022.06.014. Casu G, Porta M, Lecca LI, et al. Use of wearable inertial sensors to assess trunk and cervical postures among surgeons: effect of surgical specialties and roles. Bioengineering. 2025;12(3):299. doi:10.3390/bioengineering12030299. |
| Contributed Indexing: | Keywords: cervical ergonomics; inertial measurement units; intraoperative ergonomics; thyroid surgery; transcervical approach (TCA); transoral approach (TOA); transoral endoscopic thyroidectomy vestibular approach (TOETVA); work‐related musculoskeletal disorders (WRMDs) |
| Entry Date(s): | Date Created: 20250731 Date Completed: 20250925 Latest Revision: 20250925 |
| Update Code: | 20250925 |
| DOI: | 10.1002/ohn.1359 |
| PMID: | 40741720 |
| Database: | MEDLINE |
Nájsť tento článok vo Web of Science | Abstract: | Objective: To quantitatively assess the intraoperative cervical ergonomics of head and neck endocrine surgery and compare differences between surgical approaches.<br />Study Design: Cross-sectional assessment.<br />Setting: Operating rooms of an academic tertiary care center.<br />Methods: Intraoperative neck angles of otolaryngology attendings, fellows, and residents were recorded during head and neck endocrine surgeries. Two position sensors were affixed to the surgeon's midline between the scapulae and on the posterior scalp and calibrated at the beginning of each case. Raw quaternion data were analyzed to calculate neck angles during periods of active surgery. Neck flexion greater than 20 degrees and any degree of extension are defined as high-risk by the Rapid Upper Limb Assessment, a validated ergonomics risk tool.<br />Results: Fifteen surgeries (nine transcervical, six transoral) were recorded between five surgeons. Average time spent in active surgery was 58.5 minutes for the transcervical approach and 64.1 minutes for transoral. Percentage of time spent in high-risk neck angles was significantly higher for transcervical than transoral cases (80% [95% CI: 72%-88%] of active operating time vs 42% [95% CI: 31%-60%], P = .0001). Surgeons in transcervical cases spent more time in neck extension than surgeons in transoral cases (36% [95% CI: 19%-43%] vs 12% [95% CI: 3%-23%], P = .04). Transcervical cases resulted in neck movement across a wider range of angles compared to transoral cases, with a standard deviation of 20 versus 12 degrees (P = .02).<br />Conclusion: The transoral approach is favorable to the transcervical approach with respect to cervical ergonomics for head and neck endocrine surgeons.<br /> (© 2025 American Academy of Otolaryngology–Head and Neck Surgery Foundation.) |
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| ISSN: | 1097-6817 |
| DOI: | 10.1002/ohn.1359 |