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January 2017 Recorded Webinar - Decision Making in Peri-Laryngeal Surgeries

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Decision Making in Peri-Laryngeal Surgeries Based Upon Intraoperative Mapping of the Vegus Nerve 

Release date: January 18, 2017

Expiration date: January 18, 2019

Estimated time to complete activity: 1 hour

Description  In this presentation I emphasize the efficacy of IONM for successful identification of the anatomic variations of the peri-laryngeal vegus nerve branches and review surgical decisions we make based upon IONM data. Patients with non-recurrent nerves undergo paralysis at significantly higher rates. Abnormally short vegus nerve latency occur in ~ 2.5 % of patients and should raise suspicion for the presence of this anomaly. In addition, the use of IONM guides the decision to complete a bilateral resection or to stage the surgery in the case of a decline in evoked EMG amplitude or increase latency. Rigorous mapping of the vegus nerve during peri-laryngeal surgeries is an important adjunct to these surgeries that preserves function and guides the surgical decision-making process.

Learning Objectives At the completion of this activity, the participants will:

Discuss how IONM can map the vegus branches in peri-laryngeal surgeries
Discuss how neurophysiological data should be used to alter the course of surgery
Discuss the value and safety of continuous monitoring of the vegus nerve

Faculty Jeremy A. Bamford, PhD, Clinical Assistant Professor Department of Neurosurgery, Tulane University School of Medicine, Clinical Neurophysiologist, Nuvasive Clinical Services. 

Accreditation and Designation

Approved for

•   1.0 hour of ASNM CEUs*

ASNM Continuing Education Credit: ASNM is an ABRET approved provider of continuing education for their IONM related credentials. ABRET is the credentialing board for Electroencephalographic (EEG) Technologists, Evoked Potential (EP) Technologists, and Neurophysiologic Intraoperative Monitoring (CNIM) Technologists, Long Term Monitoring (CLTM) Technologists, and Autonomic Testing Professionals (CAP). Such crediting, however, should not be construed by program participants as endorsement of any type of instruments or supplies mentioned or involved in these presentations. Please be advised that for continuing education hours to apply towards the EEG test, they must be ASET CEUs; however, ASNM CEUs are eligible for the recertification of the EEG credential as well as towards CNIM and EP credentials and recertification.

To receive credit, you must take the evaluation at the end of the webinar. The evaluation will pop-up after the webinar has finished. Once you take the webinar the system will send you your attendance certificate. American Society of Neurophysiological Monitoring (ASNM).

If you need to close out of the webinar, please use the “X” in the webinar window – see picture below. *For more information on ASNM CEUs, please visit These CEUs are recognized and accepted by ABRET, however, ASET does not track these credits in their transcript system. It is your personal responsibility to do so.

If you have any questions or issue, please contact ASNM directly at or call (630) 832-1300.

Commercial Support None 

Faculty Disclosures
Jeremy A. Bamford, PhD, has disclosed income from Nuvasive Clinical Services.

Planner Disclosures
Patty Warf, RN MS, CNIM, FASNM, FASET, LSSGB, disclosed no relevant financial relationships.
Paul Hiller, ASNM, disclosed no relevant financial relationships.
Liz Tinley, ASNM, disclosed no relevant financial relationships.

Kent Rice, MS, REPT, CNIM, DABNM, FASNM, disclosed investment from Nuvasive.
Patty Warf, RN, MS, SNIM, FASNM, disclosed no financial relationships. 

Independent Reviewer
Jack Hastings, MD, Independent Reviewer, has disclosed no relevant financial relationships.