Surgeon Radiation Exposure in ESS Using Balloon Catheters

Objective Less invasive instruments such as balloon catheters are now available to dilate sinus ostia during endoscopic sinus surgery (ESS). Currently, balloon catheter position is confirmed under fluoroscopic visualization, which emits ionizing radiation. Radiation exposure has long been an area of concern. This study was initiated to determine radiation exposure to surgeons who used fluoroscopy with balloon catheters during ESS. Methods A multi‐center, prospective evaluation of surgeon radiation exposure was conducted. For 3 months, each sinus surgeon (9 surgeons) wore 2 dosimeters to record radiation exposure when using C‐arm fluoroscopy during surgery utilizing balloon catheter instruments. One dosimeter was placed at collar level (chest badge), outside the lead surgical apron and another dosimeter was placed on a finger (extremity badge). These dosimeters were sent for readings. Deep, eye, and shallow radiation dose for each surgeon was calculated. Results 9 chest badges recorded annualized averages of 104, 100, and 104 millirems for deep, eye, and shallow exposure respectively. 8 ring badges recorded 312 millirems. Conclusions A recent publication has reported low levels of surgeon radiation exposure during a clinical study. This study further validates that radiation exposure among experienced surgeons is well below the annual occupational radiation exposure limit (Shallow Dose Equivalent) of 50,000 millirem. With vigilant technique and education, reliance on fluoroscopy can be minimized.