Resident University of Texas Health San Antonio San Antonio, Texas
Background: Endoscopic sinus surgery has been shown to be physically demanding and may be related to significant physical fatigue and discomfort. Amongst other anatomic sites, the wrists, hands, and fingers appear to be particularly susceptible to the physical effects of performing endoscopic sinus surgery. The objective of this study was to determine if there is objective and subjective evidence of hand fatigue after performing endoscopic sinus surgery.
Methods: Grip strength was measured using the Camry Electronic Handgrip Dynamometer (CEHD) and hand dexterity was measured using the Purdue Pegboard Test (PPT). Subjective data of discomfort and disability was assessed using a modified Disabilities of the Arm, Should, and Hand Questionnaire (m-DASH) and an adapted Hand Symptom Diagram (HSD). Measurements were taken in a standardized sequence before and after performing endoscopic sinus surgery. Study subjects include fellowship-trained rhinologists (N=3) and residents in training (N=7). Five cases were analyzed per surgeon with data collection ongoing.
Results: Ten cases of endoscopic sinus surgery were analyzed. Preliminary data suggests a significant decrease in grip strength (5.0 kg, 3.7 kg decrease per surgeon, p<0.01); a trend toward decreased hand dexterity on PPT tasks (right- 1, 0.4, p<0.47; left- 1, 0.4, p<0.17); and significant subjective evidence of wrist, hand, and finger disability on the m-DASH and HSD. Data collection is ongoing and scheduled to finish in coming weeks.
Conclusions: This study demonstrates significant subjective and objective evidence of hand fatigue after performing endoscopic sinus surgery. Grip strength appears to be significantly affected while there are subtler changes in dexterity.