(1102) Ergonomic Risk and Musculoskeletal Injury Among Otolaryngology Trainees: A Systematic Review

Introduction: Otolaryngology trainees are exposed to prolonged static postures, repetitive motions, and ergonomically challenging procedures that may contribute to musculoskeletal (MSK) symptoms and injury. However, ergonomic risk among otolaryngology trainees has not been comprehensively characterized.

Methods: A systematic review was conducted in August 2025 following PRISMA guidelines. Embase, PubMed, Scopus, and Web of Science were searched for studies evaluating ergonomic risk, posture, or MSK symptoms among otolaryngology residents and fellows. Studies of attendings only, non-clinical simulations, and non-ergonomic occupational outcomes were excluded. Two reviewers independently screened studies and extracted data on study participants, procedural setting, ergonomic assessment tools, and MSK outcomes.

Results: Of 1,243 records identified, 38 studies met inclusion criteria, including approximately 878 otolaryngology trainees (588 residents, 44 fellows, and 246 fellows/residents mixed). Only 7 studies focused exclusively on otolaryngology trainees, while most included mixed populations of trainees and attendings. Objective ergonomic assessment tools were used in 10 studies, while 21 relied on subjective measures and 7 used both. Approximately half of studies evaluated ergonomic interventions, including posture modification, positioning strategies, and ergonomic education.

Conclusions: The literature demonstrates a high burden of ergonomic risk and MSK symptoms among otolaryngology trainees, with limited trainee-specific studies and substantial heterogeneity in assessment methods. These findings suggest that MSK injury risk begins during training, highlighting a critical gap in early, trainee-focused ergonomic evaluation and intervention to reduce injury risk and support long-term surgeon health.