Left-handedness in otolaryngology, who is right?

Objectives

This study aimed to ascertain the prevalence of left-handedness (LH) among otolaryngology-head and neck surgery (ORLHN) practitioners, investigate dexterity's impact on LH trainees, and identify common patterns in their training to improve the training experience.

Methods

A web-based survey was distributed anonymously via email to members of the Saudi Otorhinolaryngology Society. The survey targeted ORLHN attending consultants, board-certified registrars, and current residents. It consisted of three sections: the first focused on the experience of attending consultants in training LH individuals, the second investigated common maneuvers employed by rhinologists, and the third explored the experiences and impacts reported by LH trainees.

Results

The study included 174 participants, and found a 13.2% LH prevalence among them. Rhinologists showed disparities, with 50% advising trainees to stand on the left side of the bed and use their left hand for the scope, whereas the other half asked otherwise. Additionally, 94.4% of the participants had not encountered any courses specifically tailored for LH trainees. Among LH trainees, 57% and 41% reported difficulties in learning and performing side-specific procedures such as functional endoscopic sinus surgery and endoscopic septoplasty, respectively, often attempting to switch to their nondominant hand, and feeling disadvantaged due to their laterality.

Conclusions

Left-handedness presents challenges for both LH trainees and their trainers in surgical specialties, particularly in ORLHN, in which specific positioning and instruments are crucial to gain access to the desired surgical field. Despite these challenges, there is insufficient support for LH individuals. We recommend encouraging LH trainees to openly disclose and discuss their left-handedness, provide them with mentors, establish standardized operating room setups and techniques, supply appropriate instruments, and demonstrate flexibility in accommodating their needs.

Level of evidence

Level 5.

Assessing the Relationship Between Religious Beliefs and Ethnicity and Handedness and Footedness

Objectives The objective of the study is to explore the correlation between handedness and footedness and various demographic factors, including sex, age, faith, ethnicity, and perceived social pressures on limb use, among Muslims and non-Muslims. Methods This is an analytical cross-sectional study conducted in Saudi Arabia from September 2020 to February 2021. This research involved healthy community members aged 18 and above. An electronic survey was administered to collect demographic information on age, sex, faith, ethnicity, and the perceived degree of social pressure favoring the use of the right hand. The Waterloo handedness questionnaire (WHQ-Ar) and Waterloo footedness questionnaire (WFQ-Ar) were utilized for the assessments. Results A total of 728 respondents completed the survey. The mean (SD) age was 34.54 (11.53). Among them, 454 (62.4%) were ethnically Arab, and 507 (69.64%) identified as Muslims. The mean (SD) WHQ-Ar and WFQ-Ar scores were 42 (31.6) and 10.51 (8.1), respectively, with higher scores indicating "right" preference. Older age was associated with higher scores (p = 0.01) and men with lower handedness scores (p = 0.003). Participants who did not perceive social pressure had significantly lower scores (p < 0.001). Footedness was associated with slightly lower scores in Muslims (p = 0.001). Conclusion The degree of pressure perceived to use a particular hand has a major influence on handedness scores in Muslims and non-Muslims alike; this was true even when comparing populations with different levels of permissiveness to specific hand use due to varying religious or cultural backgrounds. Social pressure, regardless of routine religious practices, is more likely to influence handedness scores. Age and sex influence the scores similar to international reports, and footedness appears less likely to fall under the influence of cultural pressures.

Difficulties of dental practice among left-handed Tunisian students: a cross-sectional survey

In dentistry, most equipment is designed for right-handed (RH) individuals. Thus, left-handed (LH) individuals are often forced to adapt to demanding RH working conditions, and therefore, experience difficulties in their practice. The objective of this study was to determine the prevalence of left handedness among dental students at the Dental Clinic of Monastir, Tunisia, and to investigate the difficulties for LH individuals during clinical practice. A cross-sectional study was conducted among dental students during the academic year from September 2019 to March 2020. An adaptation of the Grad-Corllet Diagram and a specific questionnaire on clinical practices were administered to 221 participants. Data were analyzed using SPSS 24.0 statistical software for descriptive statistics and the chi-square test was performed (with a 5% significance level). The study revealed that 18.1% of dental students were LH. Among which, 82.5% of LH students had difficulties using instruments designed for RH dentists, 47.5% of LH students preferred the 3 o'clock working position, and 77.5% of LH students preferred to work in a sitting position. Most LH students (70%) reported that endodontic treatment was the most difficult procedure to perform. All students, whether RH or LH, presented a higher percentage of pain in the lumbar and neck/cervical regions; however, LH students presented higher values (77.5%) with statistically significant differences being reported for lower back pain (p = 0.026) and neck pain (p = 0.012). This study highlights the difficulties that LH dental students face in performing dental work. Dental Schools should provide LH students with appropriate equipment and a proper learning environment.

"I am a lefty in a right-handed world": Qualitative analysis of clinical learning experience of left-handed undergraduate dental students

BACKGROUND

Left-handedness is the preferential use of the left hand in single-handed activities such as writing. There are many studies in the literature on left-handedness in relation to professional sports, medicine and surgery. Although dentistry largely depends on manual dexterity and hand skills, there has been little research to investigate the effect of left-handedness on clinical dentistry, particularly in Australasia.

AIM

To gain an insight into the clinical learning experience of left-handed undergraduate dental students at the Faculty of Dentistry, University of Otago, New Zealand.

METHODS

Purposive sampling of left-handed students was done within the final-year class of undergraduate dental students, and they were invited to participate in a semi-structured group interview to discuss their clinical learning experience at the Faculty. Six participants agreed to participate, and the interview was recorded and transcribed verbatim. Collected data were analysed using a thematic inductive/interpretive analysis approach according to the constructivist grounded theory.

RESULTS

All participants reported having clinical difficulties being left-handed students learning using right-handed equipment. There was a common theme of experiencing hand and wrist musculoskeletal problems as well as feeling of guilt causing patient discomfort during treatment. The majority of participants reported incidents where they were told by their supervisors to learn practising dentistry with their right hand and they felt that little guidance was given on how to operate as a left-handed clinician. All participants perceived that being a left-handed operator affected their efficiency and confidence level in their early clinical years.

CONCLUSION

Left-handed students have a strong sense of adaptability. However, in order to improve the learning experience regardless of the difference in the operator's preference of dominant hand, students should be provided with appropriate equipment such as ambidextrous dental chairs and professional guidance, especially during their early career.

The Use of Orientation Templates and Free-Hand Implant Insertion in Artificial Mandibles-An Experimental Laboratory Examination in Fifth-Year Dental Students

Implant dentistry is a growing field in the education of undergraduate dental students. The present laboratory study evaluates factors which may potentially influence the accuracy of free-hand implant insertion and the use of an orientation template. After three-dimensional planning using coDiagnostiX^TM, orientation templates, including sleeves for the pilot-drill in regions 41 and 45, were manufactured by thermoforming. Sixty-one fifth year dental students inserted one implant using the orientation template and another implant free-hand in an artificial mandible. Information regarding age, sex, handedness, education, and the time required for implant insertion were recorded. Subsequently, the mandibles were scanned using cone-beam-computed tomography and the accuracy of the implant position was assessed, while statistical analysis followed. The free-hand implant insertion resulted in a distal deviation of −1.34 ± 5.15° and a mesial mismatch of 0.06 ± 0.79 mm at the artificial bone level compared to the sleeves. When using the orientation templates, the deviation decreased to −0.67 ± 3.48° and a distal mismatch of −0.22 ± 0.62 mm was achieved. The difference was statistically significant for the mismatch (p < 0.049). Regarding the limitations of our study, it could be said that the accuracy level achieved by dental undergraduates using implant placement with orientation templates is comparable to that in other studies.

Irradiance and Radiant Exposures Delivered by LED Light-Curing Units Used by a Left and Right-Handed Operator

Abstract The combination of the restoration location, the hand preference of the operator using the light-curing unit (LCU), and the design of the LCU all can have an impact on the amount of the light delivered to the restoration. To evaluate the effect of left-handed or right-handed users, the position of the operator (dentist or assistant), and the LCU design on the irradiance, radiant exposure and emission spectrum delivered to the same posterior tooth. Two light emitting diode (LED) LCUs were tested: an angulated monowave LCU Radii-Cal (SDI, Victoria, Australia) and a straight aligned multi-peak LCU Valo Cordless (Ultradent, South Jordan, UT, USA). The irradiance values (mW/cm2), radiant exposure (J/cm2) and emission spectrum were measured using a sensor in maxillary left second molar tooth. The irradiance and radiant exposure were analyzed using three-way ANOVA followed by Tukey test (a=0.05). The emission spectra (nm) were analyzed descriptively. The interaction between LCU design, operator position, and hand preference significantly influenced the irradiance and radiant exposure (P<0.001). In all cases, Valo delivered significantly higher irradiance than Radii-Cal. The handedness and the operator position affected the irradiance and radiant exposure delivered from Valo. Operator position and access affect the irradiance and radiant exposure delivered to the maxillary left second molar. The irradiance and radiant exposure can be greater when a right-hand operator is positioned on the right side of the chair and a left-hand operator is positioned on the left side of the chair. This may result in better resin composite polymerization.

A Qualitative assessment of the impact of handedness among left-handed surgeons in Saudi Arabia

Among Muslims, the use of the left hand in daily activities is discouraged; many people believe that left-handed physicians lack the competency for surgery. The study aim was to document the experience of left-handed surgeons in Saudi Arabia and the impact of handedness on their training, job performance, collegial relationships, and career progression. This qualitative study included 9 left-handed physicians in various surgical specialties from 4 major hospitals in Al-Qassim, Saudi Arabia. Face-to-face interviews using a semi-structured questionnaire were conducted. Interview transcripts were analysed with Qualitative Content Analysis Method. Of the participants, 78% were male and the mean age was 40 years. Twenty-two per cent were consultants, 67% were specialists, and 11% were resident physicians. Participants reported the following: (a) a lack of training programmes specific to handedness in undergraduate and postgraduate medical training, (b) inconvenience while being assisted by a right-handed colleague, (c) stress, fatigue, and physical pain due to the use of right-handed instruments, and (d) training of the right hand being the most common adaptation technique for a left-handed surgeon. It was concluded that left-handed surgeons experience difficulty with right-handed instruments and right-handed colleagues during surgery. It is recommended that clinical curriculum incorporate hand-specific training in surgery.