title: Comparison of microsuspension laryngoscopy positions: a randomized, prospective study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: University of Pittsburgh Voice Center, Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A.
authors.forename: Libby J
authors.initials: LJ
authors.lastname: Smith
authors.forename: Jenna M
authors.initials: JM
authors.lastname: Trout
authors.forename: Shaum S
authors.initials: SS
authors.lastname: Sridharan
authors.forename: Joan R
authors.initials: JR
authors.lastname: Guyer
authors.forename: Grace E
authors.initials: GE
authors.lastname: Owens
authors.forename: April J
authors.initials: AJ
authors.lastname: Chambers
authors.forename: Clark A
authors.initials: CA
authors.lastname: Rosen
mesh_terms: D000328:Adult; D004576:Electromyography; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D007818:Laryngeal Diseases / Q000601:surgery; D007828:Laryngoscopy; D008297:Male; D008866:Microsurgery / Q000379:methods; D018763:Muscle Fatigue / Q000502:physiology*; D018482:Muscle, Skeletal / Q000503:physiopathology*; D009140:Musculoskeletal Diseases / Q000503:physiopathology / Q000517:prevention & control*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D056888:Patient Positioning / Q000379:methods*; D011187:Posture / Q000502:physiology*; D011446:Prospective Studies
keywords: EMG; Surface electromyography; ergonomics; laryngeal surgery; laryngeal surgical ergonomics; microlaryngeal surgery; surgical ergonomics