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. 2023 Jun;75(2):784-788.
doi: 10.1007/s12070-022-03440-3. Epub 2023 Jan 21.

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

Thomas L Haupt  1 , Andrew Wadley  1 , Jamil Hayden  2 , Earl H Harley  2   3
Affiliations

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

Thomas L Haupt et al. Indian J Otolaryngol Head Neck Surg. 2023 Jun.

Abstract

Objective: Quantitatively compare the ergonomics of traditional tonsillectomy versus an endoscopic-assisted tonsillectomy. Methods: The physical positioning of the senior author was studied during a simulation of two different operative approaches to tonsillectomy: one using an endoscope and one using direct visualization without the aid of an endoscope. Whole-body postural data was collected and analyzed using the validated Rapid Upper Limb Assessments (RULA) tool to calculate the risk of musculoskeletal injuries. Results: Severe neck and trunk flexion are high-risk postures unique to the traditional approach. 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. 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. The difference between the two approaches narrowed down to the effect on neck positioning (angle decreased from > 20 degrees with traditional to nearly 0 degrees with endoscopic) and trunk positioning (angle decreased from 20 to 60 degrees with traditional to 0 degrees with endoscopic). Conclusion: An endoscopic-assisted approach to tonsillectomy allowed for a lower RULA score compared to the 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.

Keywords: Adenotonsillectomy; Endoscopes; Ergonomics; Tonsillectomy.

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Conflict of interest statement

Conflict of InterestThe authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Full Body Positioning of the traditional, non-endoscopic tonsillectomy
Fig. 2
Fig. 2
Full Body Positioning of the endoscopic-assisted tonsillectomy
See this image and copyright information in PMC

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