Division of Plastic and Reconstructive Surgery, Department of Surgery, Montefiore Medical Center, Bronx, NY.
J Craniofac Surg. 2021 Oct 1;32(7):2411-2415. doi: 10.1097/SCS.0000000000007933.
Surgical procedures with loupe magnification, headlights, and microscopes expose craniofacial surgeons to mechanical stress that can increase risk of long-term musculoskeletal pain and injury. Identifying the prevalence and cause of work-related musculoskeletal discomfort may guide preventative strategies to prolong well-being, job satisfaction, and greater duration of surgical careers.
A 29-question online survey was distributed to the surgeon members of the American Cleft Palate-Craniofacial Association. Eight hundred seventy-three surveys were distributed, and the anonymous responses were recorded using Google forms.
One hundred ninety-six unique responses were recorded (22.5% response rate). A total of 64.2% reported experiencing musculoskeletal symptoms during their career, with neck, lower back, and shoulders being the most common problem areas. Multivariate analysis demonstrated surgical loupes (odds ratio 2.36, P = 0.03) and length of surgical practice >15 years (odds ratio 1.95, P = 0.04) were independently associated with greater odds of developing symptoms. Headlights (median pain = 3, P < 0.001), loupes (median pain = 3.5, P < 0.001), and operative microscope use (median pain = 2, P = 0.02) were all associated with higher pain while operating. A total of 52.5% respondents sought medical treatments, 50.5% were concerned musculoskeletal discomfort would affect their careers, 56.6% reported a colleague that required an operation, and 30.2% reported a colleague on temporary or permanent disability.
Craniofacial surgery often involves long procedures, use of surgical adjuncts, and ergonomically straining postures, which can lead to musculoskeletal discomfort and injury. This under-reported and important phenomenon merits candid conversation and active preventative strategies to prolong surgical careers, improve professional satisfaction, and maximize patient safety.
使用放大镜、头灯和显微镜进行手术会使颅面外科医生承受机械压力，从而增加长期肌肉骨骼疼痛和受伤的风险。确定与工作相关的肌肉骨骼不适的患病率和原因可能有助于指导预防策略，以延长幸福感、工作满意度和更长的手术职业生涯。
一项包含 29 个问题的在线调查分发给了美国腭裂颅面协会的外科医生成员。共发放了 873 份调查，使用 Google 表单记录匿名回复。
记录了 196 个独特的回复（22.5%的回复率）。共有 64.2%的人报告在职业生涯中出现过肌肉骨骼症状，颈部、下背部和肩部是最常见的问题区域。多变量分析表明，手术放大镜（优势比 2.36，P=0.03）和手术实践时间>15 年（优势比 1.95，P=0.04）与出现症状的几率增加独立相关。头灯（疼痛中位数 3，P<0.001）、放大镜（疼痛中位数 3.5，P<0.001）和手术显微镜的使用（疼痛中位数 2，P=0.02）均与手术时疼痛增加相关。共有 52.5%的受访者寻求医疗治疗，50.5%担心肌肉骨骼不适会影响他们的职业，56.6%报告有同事需要手术，30.2%报告有同事处于临时或永久残疾状态。
颅面外科手术通常涉及长时间的手术、使用手术辅助工具和对姿势有潜在危害的手术体位，这可能导致肌肉骨骼不适和损伤。这种被低估的重要现象值得坦诚讨论，并采取积极的预防策略，以延长手术职业生涯、提高职业满意度和最大限度地提高患者安全。
