title: Surgeon radiation exposure in ESS with balloon catheters.
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.
  
  
  METHODS
  A multi-center, prospective evaluation of surgeon radiation exposure was conducted.
  
  
  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.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Texas Institute for Surgery, Presbyterian Hospital of Dallas, Dallas, TX 75231, USA. ford.albritton@texasmedsurg.com
authors.forename: Ford D
authors.initials: FD
authors.lastname: Albritton
authors.forename: Howard L
authors.initials: HL
authors.lastname: Levine
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Smith
authors.forename: Julian
authors.initials: J
authors.lastname: Rowe-Jones
authors.forename: Fazlur R
authors.initials: FR
authors.lastname: Zahurullah
authors.forename: Michael
authors.initials: M
authors.lastname: Armstrong
authors.forename: Don
authors.initials: D
authors.lastname: Duplan
authors.forename: James A
authors.initials: JA
authors.lastname: Gershow
authors.forename: Donald A
authors.initials: DA
authors.lastname: Leopold
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Kuhn
mesh_terms: D002404:Catheterization; D002983:Clinical Competence; D005471:Fluoroscopy / Q000009:adverse effects*; D006801:Humans; D016273:Occupational Exposure; D010254:Paranasal Sinus Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D011446:Prospective Studies; D015641:Radiography, Interventional / Q000009:adverse effects*; D013819:Thermoluminescent Dosimetry