Introduction: Work-related musculoskeletal disorders are common among otolaryngologists, resulting in decreased productivity, missed workdays, and reduced quality of life. An unacceptable ergonomic risk has been identified in common otolaryngology procedures and current ergonomic interventions lack the ability to provide real-time feedback. The aim of this study is to quantify the effects of vibrotactile feedback on intraoperative ergonomic risk during tonsillectomy.
Methods: A prospective interventional trial was conducted at a tertiary care children’s hospital. We used an ergonomic biofeedback device on attending otolaryngologists which permitted measurement of at-risk posture with and without vibrotactile feedback (VF). Intraoperative ergonomics were quantified using the Rapid Upper Limb Assessment (RULA), craniovertebral angle (CVA), and the ergonomic biofeedback device itself during tonsillectomy. Observations with and without VF were recorded, and ergonomic risk was assessed by two independent raters.
Results: Eleven surgeons wore the ergonomic biofeedback device during 126 procedures. Forty-six (37%) of the procedures were performed without VF and 80 (63%) were performed with VF. Vibrotactile feedback improved RULA neck/trunk/leg score by 0.12 (p=0.02), CVA by 2.0 degrees (p=0.01), and decreased overall time spent in an at-risk posture measured by the device by 28% (p < 0.0001). Most surgeons found that intraoperative VF was helpful. No complications or distractions related to the device were observed.
Conclusion: Use of an ergonomic biofeedback device is feasible and safe while performing surgery. Vibrotactile biofeedback significantly reduced ergonomic risk during tonsillectomy and may have a role in improving posture and preventing work-related musculoskeletal disorders.