OBJECTIVE: To explore the surgical ergonomic challenges experienced by women in otolaryngology, identify specific equipment that is ergonomically challenging, and assess the impact of suboptimal ergonomics on female otolaryngologists.

METHODS: We performed a qualitative study using an interpretive framework rooted in grounded theory. We performed semi-structured qualitative interviews of 14 female otolaryngologists from nine institutions at various stages in training and across subspecialties. Interviews were independently analyzed by thematic content analysis by two researchers and inter-rater reliability was assessed via Cohen's kappa. Differing opinions were reconciled via discussion.

RESULTS: Participants noted difficulties with equipment including microscopes, chairs, step stools, and tables as well as difficulty using larger surgical instruments, preference for smaller instruments, frustration with lack of smaller instruments, and a desire for a larger spectrum of instrument sizes. Participants reported neck, hand, and back pain associated with operating. Participants suggested modifications to the operative environment, including a wider variety of instrument sizes, adjustable instruments, and more focus and attention on ergonomic issues and the range of surgeon physiques. Participants felt that optimizing their operating room set-up was an additional burden on them, and that lack of inclusive instrumentation affected their sense of belonging. Participants emphasized positive stories of mentorship and empowerment from peers and superiors of all genders.

CONCLUSION: Female otolaryngologists face unique ergonomic challenges. As the otolaryngology workforce becomes increasingly diverse, it is important to address the needs of a diverse set of physiques to avoid inadvertently disadvantaging certain individuals.

LEVEL OF EVIDENCE: N/A Laryngoscope, 133:3034-3041, 2023.