The Ergonomics of Endoscopic Ear Surgery: An International Survey.

OBJECTIVE

To investigate the global prevalence, contributing factors and impact of work-related musculoskeletal disorders (WRMD), and ergonomics interventions and education, among otolaryngologists who perform endoscopic ear surgery (EES).

STUDY

DESIGN

Cross-sectional survey.

METHODS

A 58-item electronic survey was distributed between September 2024 and May 2025. Data were collected regarding demographics, health and lifestyle, professional training, surgical practices, WRMD, ergonomics training, and interventions.

RESULTS

There were 204 respondents from 49 countries who met inclusion criteria. For the 111 respondents (54.4%) performing EES <50% of the time and 93 (45.6%) performing EES >50% of the time, there was a lifetime prevalence of WRMD of 70.3% and 76.3% (P=0.330), 12-month prevalence of 58.6% and 65.6% (P=0.303), and 7-day prevalence of 35.1% and 40.9% (P=0.401), respectively. Respondents performing >50% EES were significantly more likely to perceive differences in WRMD when using an endoscope compared with a microscope (45.2% vs. 30.6%, P=0.033). They were also more likely to report a higher median severity of WRMD in the left chest/thoracic spine (1 [IQR: 0 to 3] vs. 2.5 [IQR: 1 to 6], P=0.035) and left lumbosacral spine (3 [IQR: 2 to 5] vs. 5 [IQR: 2 to 6.25], P=0.012). The median score for ergonomic comfort was significantly lower (7 [IQR: 6 to 8] vs. 6 [IQR: 5 to 8], P=0.035).

CONCLUSIONS

Performing a higher proportion of EES is associated with back-related WRMD and ergonomic discomfort. There is an important need to develop surgical education and implement interventions to realize the ergonomic potential of EES.