The patient and surgeon face very low radiation exposure during balloon catheter dilation of the sinus ostium, a new and increasingly popular method of minimally invasive surgery, researchers report.

according to a report in the February issue of Otolaryngology-Head and Neck Surgery.

"Although less radiation is better, and no radiation the best, fluoroscopy use with the balloon catheter tool exposes the patient and surgeon to very low amounts of radiation, and meets 'as low as reasonably achievable' principles," Dr. Christopher A. Church from Loma Linda University School of Medicine in California told Reuters Health.

Dr. Church and colleagues used dosimeters to record radiation exposure to both patients and surgeons during balloon catheter sinus ostial dilation with fluoroscopic guidance performed. Data for 108 procedures conducted on 34 patients were analyzed.

For the patients, forehead exposure ranged from 0.1 to 6.04 mSv per case (mean, 1.02 mSv), the authors report, and temple exposure ranged from 0.1 to 30.62 mSv (mean, 4.22 mSv).

The mean exposure to the anterior neck area of the surgeon was 0.072 mSv per patient or 0.025 mSv per sinus. Mean exposure to the hand was 0.023 mSv per patient or 0.0087 mSv per sinus.

Radiation exposure to the patient and surgeon was substantially higher in patients who underwent anterior-posterior projection fluoroscopy, the report indicates.

By way of comparison, the investigators say, "a patient receives an effective dose of approximately 0.04 mSv from a chest X-ray and 1.8 mSv from a head CT."

"In the United States," the researchers add, "the annual total effective dose equivalent for occupational radiation workers is limited to 0.05 Sv to the whole body, 0.15 Sv to the eye, and a shallow dose equivalent limit of 0.5 Sv to the skin of the whole body or the skin of any extremity."

Based on these limits, the surgeon could treat up to 6000 sinuses annually before reaching the occupational dose limit. With the posterior-anterior or lateral projections, the surgeon could treat more than 57,000 sinuses before reaching the occupational dose limit for the skin of the hands.

"Anterior-posterior projections shouldn't ever be necessary with this procedure," Dr. Church said, "only posterior-anterior and lateral."

"Although the exposure is low, this technology is moving toward total elimination of fluoroscopy," Dr. Church added.