12th Annual Temporal Bone Surgical Course Parking There are several visitor parking garages on the University Hospitals campus: CID 2504 Registration Form • Adelbert Road Parking Garage accessible from Adelbert Road and located next to Rainbow Babies and Children’s Hospital. It connects to the hospital buildings via a tunnel on the basement level. FOUR WAYS TO REGISTER • UH Drive Parking Garage accessible from UH Drive, south of Euclid Avenue. yourWAYS credit TO card, through July 21 FOUR REGISTER Case University or credit card 2. Western Mail thisReserve registration form with with your check checknumber payable to to 2. form payable 1. Mail Mail this this registration form with your check your or credit card number to: Registrar, CME Program, 10524 Euclid Ave. FOUR FOUR WAYS WAYS TO TO REGISTER REGISTER Case Western Reserve University or credit card number Case Western Reserve University10524 or credit card number FOUR WAYS TO REGISTER to: Registrar, CME Program, Euclid Avenue, to: Registrar, Registrar, CME Program, 10524 Euclid Euclid Ave. Ave. Cleveland, OH to: Program, 10524 1.1.44106-6026 Register Register online online atathttp://casemed.case.edu/cme http://casemed.case.edu/cme with with Cleveland, OHCME 44106-6026 Cleveland, OH 44106-6026 your your credit creditcard, card,through throughJuly July2121 1. online atOH http://casemed.case.edu/cme with 44106-6026 3. Register Fax2. thisCleveland, form to 216-844-8133 Fax thiswith formyour withcredit your card creditnumber card number to 216-844-8133 3. Fax this form with your credit card number to 216-844-8133 2. 2. Mail Mail this this registration registration form form with with your your check checkpayable payabletoto 3. credit Fax this formthrough with your to 216-844-8133 your card, Julycredit 21 card number 4. Call3.216-983-1239 or 1-800-274-8263 with the Phone 216-983-1239 or 800-274-8263 with the Case CaseWestern Western Reserve ReserveUniversity University ororcredit creditcard cardnumber number 4. Call Call 216-983-1239 216-983-1239 or 1-800-274-8263 1-800-274-8263 with the 4. or with the information requested below and yourpayable credit card number information requested below and your credit card number to:to:Registrar, Registrar, CME CME Program, Program, 10524 10524 Euclid Ave. Ave. 2. Mail this registration form with your check toEuclid information requested below and your credit card number information requested below and your credit card number Cleveland, Cleveland, OH OH 44106-6026 44106-6026 4. Register online at http://casemed.case.edu/cme Case Western Reserve University or credit card number thisform formwith withyour yourcredit creditcard cardnumber numbertoto216-844-8133 216-844-8133 3.3.Fax Faxthis Name to:Name Registrar, CME Program, 10524 1-800-274-8263 Euclid Ave. with Name 4.4.Call Call216-983-1239 216-983-1239oror1-800-274-8263 withthe the ________________________________________ Name Cleveland, OH 44106-6026 information informationrequested requestedbelow belowand andyour yourcredit creditcard cardnumber number SSN (last 4 digits) SSN4(last 4 digits) SSN (last digits) 3. Fax this form with your credit card number to 216-844-8133 ________________________________________ DegreeSSN (last 4 digits) Name Name BusinessPhone Phone Business Business Phone 4. Call________________________________________ 216-983-1239 or 1-800-274-8263 with the Degree(s) Degree(s) SSN SSN (last (last 4 digits) 4 digits) Telephone Street Address information requested below and your credit card number Street Address Street Address ________________________________________ Business Business Phone Phone City/State/ZIP Street City/State/ZIP ___ Enclosed is mymy: check to:MasterCard q Discover Card Charge VisaReserve qpayable q ___ Charge Case Western University ___ my: Visa MasterCard q q q Discover Card ___ ___ Enclosed Enclosed is ismy my check check payable payableto:to: Western Reserve University StreetCase Address Case CaseWestern WesternReserve ReserveUniversity University _______ Charge my: ❑ Visa ❑ MasterCard ❑ Discover Card CardNumber Number ___ Charge my:___ Visa Discover Card qCharge qmy:MasterCard qMasterCard Card ___ Chargemy: Visa qqMasterCard DiscoverCard Card qqVisa qqDiscover City/State/ZIP ________________________________________ SecurityCode Code Security Security Code ________________________________________ Tuition: $75.00Signature Signature Signature ___ Enclosed is my check payable to: here Signature detach detachform formhere here Card Number Conference tuition includes all educational sessions, materials, refreshments, continental breakfast both days, and lunch on Friday. Register by mail using the tear-off form, or by fax, phone or online with a credit card. Advance payment secures your participation in the program. Attendance is limited. Late Registration and Cancellation Policy After Friday, October 3 please register on a space available basis by calling the CME Program at 216-983-1239 or 800274-8263. Full refunds will be made for cancellations on or prior to October 3 only. Cancellations received after that date will require a $50.00 administrative fee. 2014 University Hospitals © 2014 University Hospitals ©©2014 University Hospitals Cleveland, OH 44106 _______ Enclosed is my check payable to: Exp. Date The Glidden House (0.5 miles to University Hospitals) 1901 Ford Drive Cleveland, OH 44106 216-231-8900 www.gliddenhouse.com Registration Information Email Email Tuition: $75.00 ___ Enclosed Enclosed my check check payable payable to: to: ___ isis my Tuition: $400.00 Tuition: Tuition:$75.00 $75.00 Business Phone Case Western Reserve University Case Western Reserve University ________________________________________ Signature Signature Exp. DateSecurity Code Exp. Exp. Date Date Security Security Code Code Courtyard by Marriott – University Circle (0.1 miles to University Hospitals) 2021 Cornell Road Cleveland, OH 44106 1-800-MARRIOTT www.marriott.com/clece 11100 Euclid Ave., MSC-9160 11100 Euclid Ave., 11100 EuclidMedical Ave.,MSC-9160 MSC-9160 Continuing Education Program Cleveland, Cleveland, OH 44106 OH 44106 11100 Euclid Ave., MSC-9160 Cleveland, OHAvenue 44106 10524 Euclid 11100 Euclid MSC-9160 Cleveland, OHAve., 44106 Cleveland, OH 44106-6026 Email Email City/State/Zip City/State/ZIP City/State/ZIP Email Tuition: Tuition: $75.00 $75.00 Degree(s)________________________________________ SSN (last 4 digits) Email Email Lodging Please contact these facilities directly to determine availability and make your reservation. For information on other accommodations in the University Circle area call the CME Program at 216-983-1239 or 800-274-8263. City/State/ZIP Street Street Address Address Name ________________________________________ Exp.Date Date Exp. Card Number Card Card Number Number You are responsible for your own parking charges. h form here h form here Degree(s) Degree(s) Degree(s) • Health Sciences Parking Garage located under the Biomedical Research Building and accessible from Circle Drive or Emergency Drive. Bolwell Conference Center is located across the street from the Emergency Drive entrance. October 17 & 18, 2014 ntinuing Medical Education 1. Register online at http://casemed.case.edu/cme with FOUR WAYS TO REGISTER FOUR WAYS TO REGISTER Registration Form your credit card, through July 21 Registration 1. Register RegisterForm online at at http://casemed.case.edu/cme http://casemed.case.edu/cme with with 1. online Registration Registration Form Form 2. Mail this registration with your21check payable to your credit card,form through July With an Update in Otologic Surgery anaging Concussion in Youth: Guidelines and Best Practices lines and Best Practices anaging Concussion in Youth: Guidelines and Best Practices uidelines andMedical Best Practices ing MContinuing e dic al and EducMedical ation Education uidelines Best Education Practices ntinuingContinuing Medical Education After Friday, October 3, register by calling the CME ProgramForm at 216-983-1239 or 800-274-8263. Registration Form Registration 12th Annual Temporal Bone Surgical Course Register online26, at: http://casemed.case.edu/cme Saturday, July 26, rday, July 2014 Saturday, July 26, 2014 2014 aturday, July 26, 2014 aturday, July 26, 2014 Managing Concussion in ging Concussion in Youth: Managing Concussion in Youth: Youth: With an Update in Otologic Surgery University Hospitals Case Medical Center 11100 Euclid Avenue Cleveland, Ohio Presentedby: by: Presented Presented by: Presented Presented by:by: Presented by: Ear, Nose & Throat Institute Sponsoredby: by: Sponsored Sponsored by:by:by: Sponsored Sponsored Sponsored by: Presenters Faculty KEYNOTE SPEAKER Presenters Program Agenda 12th Annual Temporal Bone Surgical Course begins Gerard Gioia, PhD Chief, Division of Neuropsychology Director, SafePhD Concussion Outcome Friday, October 17 Guest Faculty Gerard Gioia, With an Update in Otologic SurgeryMedical Case Recovery Education (SCORE) Program Chief, Division&of Neuropsychology Children’s National Medical Center 8:00 8:30 AM Registration and Continental Breakfast Dennis I. Bojrab, MD Director, Safe Concussion Outcome n October 17 Reserve & 18, 2014 Center for Neurosciences Research Clinical Associate Professor of &Otolaryngology, Wayne State Recovery Education (SCORE) Program der in medical Associate Professor of Psychiatry 8:30 - 8:45 AM Introduction Children’s National Medical Center University Hospitals Case Medical Center University andfor Behavioral Sciences, and Pediatrics ed among Maroun Semaan, MD; Cliff A. Megerian, MD the Neurosciences Research Chief Executive Officer,Center Michigan EAR Institute 11100 Euclid Avenue George Washington University Professor Providence of Psychiatry Hospital, Medical Director,& SkullAssociate Base Surgery, by U.S. News Cleveland, Ohio of Medicine Sciences 8:45 - 9:30 AM Modern Approaches to andSchool Behavioral Sciences,and andHealth Pediatrics Southfield, MI Washington, DC ments at Case George Washington University Cholesteatoma Surgery KEYNOTE SPEAKER with Chairman of Otolaryngology Section, William Beaumont Dennis I. Bojrab, MD ne, physicians Hospital, Royal Oak, MISchool of Medicine and Health Sciences FACULTY Washington, DC edical car e Christopher Bailey, PhD 9:30 - 9:40 AM Move to Laboratory Learning Objectives Overview Western Course Director Reserve University at bring theCase FACULTY 9:40 - 11:50 AM Laboratory Dissection Following completion of this program participants will be Overview Knowledge of sports concussion has changed substantially • Intact Canal Mastoidectomy able to: • Facial Recess Approach in the past 20 years. Unfortunately, many athletes do not • Recognize the latest clinical and surgical strategies in obtain appropriate evaluation or management concussion Knowledge of sports concussion has changed of substantially the treatment of cholesteatoma Noon - 1:00 PM Lunch which can lead prolonged recovery, repeated injury in • theDemonstrate past 20 to years. Unfortunately, many athletes do not intact canal mastoidectomy dissection, and catastrophic outcomes. TheorState ofcanalplasty, Ohio has passed obtain appropriate evaluation management of concussion canal wall down mastoidectomy, facial 1:00 - 1:45 PM Stapes Surgery for Otosclerosis legislation governing the evaluation andendolymphatic management of which can lead to prolonged recovery, repeated injury sac nerve decompression dissection, Dennis I. Bojrab, MD concussion, a key feature which requires thathas athletes and catastrophic outcomes. The State of Ohio passed decompression, andofshunt, posterior semicircular 1:45 - 2:00 PM Move to Laboratory canal surgery and labyrinthectomy who have sustained a suspected concussion undergo of legislation governing the evaluation and dissection management • Recognize the etiologies of stapes fixation and evaluation by aankey appropriate provider who is trained concussion, feature of medical which requires that athletes tic 2:00 - 5:00 PM Laboratory Dissection understand themanagement of concussion modern surgical in who the evaluation and of concussion. have sustained amethods suspected undergo • Canal Wall Down Mastoidectomy neur ology , management of otosclerosis including stapedectomy evaluation by an appropriate medical provider who is trained • Canalplasty and other in the evaluation and management of concussion. • Facial Nerve Decompression Directorof of Concussion Program, UH Neurological Institute School Medicine Christopher Bailey, PhD Assistant Professor of Neurology Course Director Case Western Reserve University of Medicine Maroun MD Director ofSemaan, Concussion Program, UH School Neurological Institute Course Director Assistant Professor of Neurology Philip Fastenau, PhD Associate Professor Otolaryngology Head & Neck Surgery Case Western Reserveof University School of – Medicine Course Co-Director Department of Otolaryngology – Head & NeckCenter Surgery Director of Neuropsychology, UH Case Medical Philip Fastenau, PhD UH Case Medical Center Professor of Neurology Course Co-Director Case Western Reserve University School of Medicine Director of Neuropsychology, UH Case Medical Center Joseph Carter, MD Professor Neurology NancyofProfessor Bass, MDof Otolaryngology – Head & Neck Surgery Associate Case Western Reserve University School of Medicine Division of Pediatric Neurology Chairman, Department of Otolaryngology – Head & Neck UH Rainbow Babies & Children’s Hospital Nancy Bass, MD Surgery Associate Professor of Pediatrics Division of Pediatric Neurology MetroHealth Medical Case Western ReserveCenter University School of Medicine UH Rainbow Babies & Children’s Hospital Associate Professor of Pediatrics PT, DPT Michele Hippler-Brant, Sam E. Kinney, MD asCase Western Reserve University of Medicine Lead Outpatient Therapist, St. John Medical Center Clinical Associate Professor ofSchool Otolaryngology – Head & Neck n, as well Who Should Attend/Course Description About the Brain Health & Memory Center community 5:00 PM Adjourn for the day Surgery Michele JeffreyHippler-Brant, Janata, PhD PT, DPT This program is intended for practicing ENTs and graduating s in the Past President, American Otological Society Lead Outpatient Therapist, St. John UH Medical Center Director, Division of Psychology, Case Medical Center About the Brain Health & Memory Center For over 20 years, the Brain Health Memorysurgery Center at senior residents interested in an &otologic update Associate Professor of Psychology cussion Jeffrey Janata, PhDMD University providedand exemplary care andsessions support Cliff A.Western Megerian, through Hospitals a series has of lectures lab dissection Case Reserve University School of Medicine etur n to play . Director, Division of Psychology, UH Case Medical Center forusing families who are affected by disorders of lectures memory and For over 20 years, the Brain Health & Memory Centerwill at be Saturday, October 18 Professor and Chair, Department of Otolaryngology – Head temporal bone specimens. Faculty Jonathan Miller, MD Associate Professor of Psychology cognition (mental processes). The goal of treatment is support to & Neck Surgery complemented by closely mentored, hands-on University Hospitals has provided exemplary carelab andsessions Director, Center forUniversity FunctionalSchool & Restorative Neurosurgery Case Western Reserve of Medicine 8:00 8:30 AM Registration and Breakfast Richard W. & Patricia R. Pogue Chair in Auditory Surgery and improve cognitive as by well asinteraction the overall quality offering opportunities for dynamic with faculty. for families who functions are affected disorders of memory andof UH Case Medical Center Jonathan Miller, MD Hearing Sciences participant will have The access lifeEach for our patients. The center specializes in state-of-the-art state-of-the-art Assistant Professor of Neurosurgery cognition (mental processes). goaltoof atreatment is to 8:30 - 9:30 AM Endolymphatic Sac Surgery Director, Center for Functional & Restorative Neurosurgery Director, Department Otolaryngology – Head & Neck 10-station lab equipped with a microscope with a flat panel Case Western Reserve of University School of Medicine evaluation and treatment using research andof improve cognitive functions as collaborative well as the overall quality Case Discussion UH Case Medical Center Surgery monitor and the latest dissection and drilling equipment. care developed thespecializes Department of Neurology lifepractices for our patients. Thewith center in state-of-the-art MaryDirector Solomon, DO Assistant Professor of Neurosurgery Maroun Semaan, MD; Cliff Megerian, MD; Medical of Cochlear Implantation y School of atevaluation Case Western Reserve University School of Medicine and Pediatrics Medicine, UH Rainbow Babies & Children’s Hospital Case WesternSports Reserve University School of Medicine and treatment using collaborative research and Dennis Bojrab, MD; Joseph Carter, MD; UH Case Medical Center Assistant Professor of Pediatrics Continuing Education vity , the University Neurological Institute.Dir This joint ector Sam Kinney, MD care practicesHospitals developed with the Department of Neurology Mary Solomon, DO Case Western Reserve University School of Medicine initiative ourReserve specialists accessSchool to the of latest research faculty (that at Caseallows Western University Medicine and Pediatrics Sports Medicine, UH Rainbow Babies & Children’s Hospital Meeting Location 9:30 - 9:40 AM Move to the laboratory Case Western Reservepharmaceuticals University School Medicine from institutes, andof top physicians Amanda Weiss-Kelly, MD Assistant Professor of Pediatrics the national University Hospitals Neurological Institute. This joint is of the Director, Pediatrics Medicine accredited by the Accreditation Council for Continuing Case Western Reserve Sports University School of Medicine around the world. initiative allows our specialists access to the latest research icipants all 9:40 - Noon Laboratory Dissection UH Rainbow BabiesCase & Children’s University Hospitals MedicalHospital Center Medical Education to provide continuing medical education from national institutes, pharmaceuticals and top physicians Amanda Weiss-Kelly, MD • Endolymphatic Sac Decompressoin al inter ests. Associate Professor For information on brain health at University 11100 Euclid Avenueof Pediatrics formore physicians. Director, PediatricsReserve Sports Medicine around the world. • Posterior Semicircular Canal Surgery Case Western University School of Medicine Cleveland, Ohio s Hospitals prior to Neurological Institute, call 216-844-2724 or visit UH Rainbow Babies & Children’s Hospital Case Western Reserve University School of Medicine • Labyrinthectomy UHhospitals.org/Neuro. Brent Woodside, ATC/L, ter n Associate Professor Pediatrics NASM-PES For more information on brainfor health at University Lectures: BolwellofConference Center, Conference Room A designates this live activity a maximum of Reserve 10 AMA Head Athletic Trainer TM Case Western Reserve University School of Medicine (1st Floor, Bolwell Building) PRA Category 1 Credits . Physicians should claim or only the at faculty Noon Conference Adjourns Hospitals Neurological Institute, call 216-844-2724 visit Performance and Conditioning Coach credit commensurate with the extent of their participationavailable UHhospitals.org/Neuro. Brent ATC/L, NASM-PES best Laboratory: Anthony J. Maniglia and Neck Surgical LakeWoodside, Erie Monsters, American HockeyHead League in the activity. Head Athletic Trainer Laboratory, Lakeside Building Room 4079 (4th floor) y discussion of eutical Performance and Conditioning Coach products Lake Erie Monsters, American Hockey League The commitment to exceptional patient care begins with revolutionary discovery. University Hospitals Case Medical The commitment exceptional patient careWestern begins with Center is theto primary affiliate of Case Reserve The commitment to exceptional patient care begins revolutionary discovery. University Hospitals Case Medical University School of Medicine, a national leader with revolutionary discovery. University Hospitals Casein medical Center isCenter the primary affiliate and of Case Western Reserveamong the Medical is the primary affiliate of Case ranked Western research and education consistently University School of Medicine, a national leader medical Reserve University School of Medicine, a national top research medical schools in the countryinleader by U.S. News & and education and consistently ranked among inresearch medical research and education and consistently World Report. Through their faculty appointmentsthe at Case ranked amongmedical the topschools research medical schools in News thephysicians top research in the country by U.S. & Western Reserve University School of Medicine, country by U.S. News & World Report. Through their World Through their faculty at Case atReport. UH Case Medical Center areappointments advancing medical care faculty appointments at CaseSchool Western University Western Reserve University of Reserve Medicine, through innovative research and discoveryphysicians that bring the School of Medicine, physicians at UH Case Medical at UHlatest Case Medical Center aretoadvancing treatment options patients. medical care Center are advancing medical care through innovative through innovative research and discovery that bring the research and discovery that bring the last treatment latest treatment options to patients. options to patients. Who Should Attend Disclosure Who Should This event is Attend designed to assist coaches, athletic trainers, physicians (pediatrics, primary care, neurology, The of Case Western Reserve University School of other neurosurgery, orthopaedics, sports medicine) and This policy event is designed to assist coaches, athletic Medicine CME Program requires that thecare, Activity Director, health care providers whoprimary manage concussion, as well as trainers, physicians (pediatrics, neurology, planning committee members andmedicine) all activity faculty school administrators and the Northeast Ohio community neurosurgery, orthopaedics, sports and other (that is,care anyone in understanding a position to control thepractices content ofas in general, in the best in the health providers who manage concussion, as well the education activity) disclose the activity participants identification andand management of sports concussion school administrators the to Northeast Ohio community all relevant financial relationships with commercial and the for determining fitness forthe return to play. in general, in methods understanding the best practices in interests. Disclosure will be madeoftosports activity participants identification and management concussion prior to the commencement of the fitness activity.for Case Western and the methods for determining return to play. Reserve University School of Medicine also requires that Faculty Disclosure faculty make clinical recommendations based on the best available scientific evidence and that faculty identify Faculty Disclosure The policy of Case Western Reserve University School of any discussion of “off-label” or investigational use of Medicine CME Program requires that the Activity Director, pharmaceutical products or medical devices. planning committee and all activity faculty The policy of Case Westernmembers Reserve University School of (that is, anyone in a position to control the content of the Medicine CME Program requires that the Activity Director, education activity) disclose to the activity participants planning committee members and all activity faculty (that all relevant commercial is, anyone in afinancial positionrelationships to control thewith content of the interests. Disclosure will be made to activity participants education activity) disclose to the activity participantsprior all to the commencement of the activity. Case Western relevant financial relationships with commercial interests.Reserve University School also requires that Disclosure will be madeoftoMedicine activity participants prior tofaculty make clinical recommendations based on the best the commencement of the activity. Case Western Reserveavailable scientific evidence and that identify any discussion of University School of Medicine alsofaculty requires that faculty “off-label” or investigational use of pharmaceutical make clinical recommendations based on the best availableproducts or medical devices. scientific evidence and that faculty identify any discussion of “off-label” or investigational use of pharmaceutical products or medical devices.
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