Surgeon radiation exposure in ESS with balloon catheters
Presented at the Annual Meeting of the American Academy of Otolaryngology–Head and Neck Surgery, September 22, 2008, Chicago, IL.
Received 13 September 2008; received in revised form 16 December 2008; accepted 13 January 2009.
Abstract
Objective
Less invasive instruments such as balloon catheters are available for sino-ostial dilation during endoscopic sinus surgery (ESS). Currently, balloon catheter position is confirmed under fluoroscopic visualization. Radiation exposure has been an area of concern. This study was initiated to determine surgeon radiation exposure when fluoroscopy is used during ESS with balloon catheters.
Study Design
A multi-center, prospective evaluation of surgeon radiation exposure was conducted.
Subjects and Methods
For three months, 14 sinus surgeons wore dosimeters to record radiation exposure while using C-arm fluoroscopy during balloon catheter-aided sinus surgery. One dosimeter was placed at collar level (chest), outside the lead apron and another dosimeter was placed on a finger (extremity). These dosimeters were sent for readings. Deep, eye, and shallow radiation dose for each surgeon was calculated.
Results
Thirteen chest badges recorded annualized averages of 191.08, 193.54, and 187.69 mrems for deep, eye, and shallow exposure respectively. Eleven ring badges recorded 584.00 mrems.
Conclusions
A recent publication reported low levels of surgeon radiation exposure during ESS with balloon catheters. This study validates radiation exposure among experienced surgeons is well below the annual occupational radiation exposure limit of 50,000 mrem. With vigilant technique and education, fluoroscopy reliance can be minimized.
aDepartment of Otolaryngology–Head and Neck Surgery, Texas Institute for Surgery, Presbyterian Hospital of Dallas, Dallas, TX
bCleveland Nasal Sinus and Sleep Center, Cleveland, OH
cEar Nose and Throat Associates of Chester County, Exton, PA
dRoyal Surrey County Hospital NHS Trust, Surrey, UK
eDepartment of Otolaryngology–Head and Neck Surgery, Rockford Health Physicians, Rockford Health System, Rockford, IL
Corresponding author: Ford D Albritton IV, MD, Presbyterian Hospital of Dallas, Chairman, Department Otolaryngology–Head and Neck Surgery, Texas Institute for Surgery, 8440 Walnut Hill Ln, Suite 500, Dallas, TX 75231
Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.
ABSTRACT