title: Endoscopic sinus surgery and musculoskeletal symptoms.
abstract: Endoscopic sinus surgery is a common surgical procedure, with low morbidity for patients. Studies have shown that endoscopic and laparoscopic surgeons have a significant risk of developing musculoskeletal symptoms, with potential adverse effects on their careers as well as patient care. We aimed to identify the prevalence of such symptoms, and any associated risk factors relating to surgical technique, in European rhinologists.
  
  
  
  An online survey was distributed to all members of the European Rhinologic Society and data collected for statistical analysis. The relevant literature was reviewed, and ergonomic recommendations made.
  
  
  
  There were 250 responses, with nearly 80% of surgeons experiencing musculoskeletal symptoms. The neck and back were the most common site of symptoms, in approximately 60% of cases. There were significant correlations between musculoskeletal symptoms and the number of procedures performed each year, operating in a standing position, and operating without a monitor.
  
  
  
  There is a high prevalence of musculoskeletal symptoms in endoscopic sinus surgeons, which appears to be particularly related to posture during surgery. Surgeons need to be more aware of the risk factors, and good ergonomic habits should be encouraged to try and reduce the development of such symptoms.
authors.affiliation: ENT Department, Monash Health, Melbourne, Australia.
authors.forename: Joanne
authors.initials: J
authors.lastname: Rimmer
authors.affiliation: ENT Department, Mater Misericordiae University Hospital, Dublin, Ireland.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Amin
authors.affiliation: Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, the Netherlands.
authors.forename: Wytske J
authors.initials: WJ
authors.lastname: Fokkens
authors.affiliation: Professorial Unit, Royal National Throat Nose and Ear Hospital, London, United Kingdom.
authors.forename: Valerie J
authors.initials: VJ
authors.lastname: Lund
mesh_terms: D000328:Adult; D001416:Back Pain / Q000453:epidemiology*; D004724:Endoscopy; D006804:Ergonomics; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000453:epidemiology*; D019547:Neck Pain / Q000453:epidemiology*; D009784:Occupational Diseases / Q000453:epidemiology*; D016272:Occupational Health; D010036:Otolaryngology; D010256:Paranasal Sinuses / Q000601:surgery*; D010292:Paresthesia / Q000453:epidemiology*; D015995:Prevalence; D020069:Shoulder Pain / Q000453:epidemiology; D066231:Surgeons / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires