Comparison of microsuspension laryngoscopy positions: a randomized, prospective study.

Objectives/hypothesis: To evaluate muscle fatigue and participant pain in the upper back, cervical, and arm muscles associated with microlaryngeal surgery (MLS) in standardized favorable and unfavorable ergonomic positions.

Study Design: Individual randomized counterbalanced design.

Methods: Electromyographic sensors were placed on targeted muscles involved with performing MLS on 18 otolaryngology residents/fellows. Subjects were randomly counterbalanced in both favorable and unfavorable positions while completing simulated laryngeal microsurgical tasks. Participants reported their extent of muscle discomfort in targeted muscle regions on a standardized survey.

Results: Muscle fatigue and self-reported pain were reduced, and productivity was improved in the favorable position. In the lower trapezius, significantly less muscle activation (P = 0.025) and less pain (P < 0.05) were found while in the favorable position compared to the unfavorable position.

Conclusion: This is the first study to demonstrate electromyographic evidence of decreased muscle activation and fatigue, in addition to self-reported pain with a more favorable microsurgical ergonomic position, which may help surgeons avoid musculoskeletal injuries.