6th MIGRAINE. surgical treatment of HEADACHES. Annual Symposium ON THE. Saturday and Sunday October 6-7, 2012

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1 THE 6th surgical treatment of Saturday and Sunday October 6-7, 2012 School of Medicine Course Director Didactic Presentations Live Surgical Demonstration Cadaver Lab Live Demonstration of Botulinum Toxin A Endorsed By: Presented By: Sponsored By:

2 THE 6th surgical treatment of OVERVIEW CTENTS Migraine headache is a chronic, often incapacitating condition that afflicts approximately 28 million Americans (12% of the population), disproportionately affecting more females (18%) than males (6%). Despite its prevalence, this condition remains largely under diagnosed and under treated. This quintessential course will educate participants in the surgical techniques that have been developed over the last ten years to treat the four most common migraine trigger sites with a success rate of approximately 90%. This course will encompass an in-depth overview of the symptoms and diagnosis of migraines; discussion of the role of botulinum toxin A in treatment of migraine headaches and identification of the trigger sites; didactic and video presentation of anatomy, surgical techniques, advantages and risks of surgery; a live surgical demonstration and a half day cadaver lab with hands on practice of surgical technique Learning Objectives Faculty Agenda General Information & Registration Cadaver Lab Information The commitment to exceptional patient care begins with revolutionary discovery. University Hospitals Case Medical Center is the primary affiliate of School of Medicine, a national leader in medical research and education and consistently ranked among the top research medical schools in the country by U.S.News & World Report. Through their faculty appointments at the School of Medicine, physicians at UH Case Medical Center are advancing medical care through innovative research and discovery that bring the latest treatment options to patients.

3 LEARNING OBJECTIVES WHO SHOULD ATTEND? This program is designed for practicing plastic surgeons, neurosurgeons, neurologists and otolaryngologists. THEsurgical 6th treatment of LEARNING OBJECTIVES After attending this course, participants will be able to: Identify the symptoms of migraine headaches with emphasis on involvement of a neurologist as a team member Recognize the constellation of symptoms that aid in identifying the migraine trigger site Explain the potential pathophysiology of each trigger site Recognize the use of botulinum toxin A injections as a prognosticator and treatment modality Explain the preoperative patient work-up and selection of the surgical technique Describe the detailed surgical treatment of migraine headaches Manage adverse effects Apply the surgical techniques practiced at the hands-on cadaver lab

4 LIVE SURGERY DIRECTOR Chair and Kiehn-DesPrez Professor School of Medicine University Hospitals Case Medical Center COURSE DIRECTOR Jeffrey Janis, MD Associate Professor University of Texas Southwestern Medical Center Dallas, Texas Robert Daroff, MD Chair Emeritus and Professor Department of Neurology School of Medicine University Hospitals Case Medical Center LAB DIRECTOR David Branch, MD Bangor Plastic & Hand Surgery, Bangor, Maine Deborah Reed, MD The American Migraine Center Clinical Instructor Department of Neurology School of Medicine PROGRAM DIRECTOR David Stepnick, MD Associate Professor Associate Professor Department of Otolaryngology-Head and Neck Surgery School of Medicine University Hospitals Case Medical Center Ali Totonchi, MD Assistant Professor School of Medicine

5 AGENDA THE 6th surgical treatment of Saturday, October 6, :00 am Registration, Continental Breakfast and Exhibits 7:25 am Welcoming Remarks Course Director 7:30 am Overview of Migraine Headaches and Their Treatment Robert Daroff, MD 8:00 am Selection of Surgical Candidates & Identification of Trigger Sites Deborah Reed, MD 8:30 am Anatomy of the Zygomaticotemporal Branch of the Trigeminal Nerve (ZTBTN) Ali Totonchi, MD 8:40 am Anatomy of the Occipital Nerve Jeffrey Janis, MD 9:00 am Anatomy of the Supraorbital and Supratrochlear Nerves Jeffrey Janis, MD 9:15 am Elimination of Perinasal Migraine Trigger Sites David Stepnick, MD 9:45 am Question and Answer Session 9:55 am Coffee Break 10:15 am Pre and Postoperative Management of Migraine Patients David Branch, MD 10:40 am Surgical Treatment of Migraine Headaches 11:40 am Panel Discussion Panelists: David Branch, MD; ; Jeffrey Janis, MD; David Stepnick, MD 12:30 pm Live botulinum toxin A injection for Treatment of Migraine Headaches and Detection of the Trigger Site 12:40 pm Lunch and Exhibitors 1:30 pm Live Surgical Demonstration of All Four Trigger Sites Moderated by: David Stepnick, MD (Operating Room) Jeffrey Janis, MD (Auditorium) Video Demonstration of Septoplasty and Turbinectomy for the Treatment of Migraine Headaches David Stepnick, MD 5:00 pm Panel Discussion and Wrap Up 5:30 pm Adjourn Sunday, October 7, :45 am Registration 8:30 am Cadaver Lab 11:30 am Adjourn

6 GENERAL INFORMATI REGISTRATI Meeting Location Richard E. Celeste Biomedical Research Building 2109 Adelbert Road Frohring Auditorium, Room 105 Parking Parking is available in the Health Sciences Parking Garage under the Biomedical Research Buliding or the Adelbert Road Parking Garage adjacent to Rainbow Babies and Children s Hospital. (detailed directions will be sent with the confirmation letter). Bring your parking pass to the registration desk for validation. Accreditation School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. School of Medicine designates this live activity for a maximum of 12 AMA PRA Category 1 Credits TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Lodging Information The Glidden House (0.5 miles to University Hospital) 1901 Ford Drive Phone Washington Place Bistro & Inn (0.4 miles to University Hospital) 2203 Cornell Road Phone Wyndham at Playhouse Square (4 miles to University Hospital) 1260 Euclid Avenue Phone: The Ritz-Carlton Cleveland (10 miles to University Hospital) 1515 West Third Street Phone Please contact these facilities directly to determine availability and make your reservation. For information on other accommodations in the University Circle area call the Continuing Medical Education Program at Full registration includes tuition, educational materials, live surgical demonstration, cadaver lab, continental breakfast, lunch and breaks on Saturday. All registrations will be accepted on a space-available basis. Registration fees are refundable less a $125 administrative fee if participant cancels by September 25, No refunds will be made after September 25, All requests for refunds must be made in writing. Four Ways to Register 1. Register on-line at with a credit card 2. Mail this completed form with a check payable to or complete the credit card information and send to: Continuing Medical Education Program Euclid Avenue, Fax this form with your credit card number to (216) Phone (216) or (800) with the information requested below and your credit card number. THEsurgical 6th treatment of CID# 2440 Saturday and Sunday October 6-7, 2012 Name Degree Specialty Address City State Zip SSN (last 4 digits) Phone Fax Both Events $1,650 Saturday only $900 I am a University Hospitals employee (50% discount applies) The policy of School of Medicine CME Program requires that the Activity Director, planning committee members and all activity faculty (that is, anyone in a position to control the content of the education activity) disclose to the activity participants all relevant financial relationships with commercial interests. Disclosure will be made to activity participants prior to the commencement of the activity. School of Medicine also requires that faculty make clinical recommendations based on the best available scientific evidence and that faculty identify any discussion of off-label or investigational use of pharmaceutical products or medical devices. Checks payable to or provide credit card information. Mastercard VISA Discover Credit Card # Card Expiration Date Signature Date Dietary Restrictions?

7 CADAVER LAB INFORMATI This unique cadaver lab offers participants hands-on practice of the surgical techniques used to treat the four most common migraine headache trigger sites under the guidance of the symposium faculty. Participants will improve their knowledge, understanding and ability to perform these migraine surgical techniques independently. Participants registering for the cadaver lab will be required to bring the following instruments: THEsurgical 6th treatment of 2 Mosquitoes 2 Curved Hemostats 1 Needle Holders Straight Iris Scissors Metzenbaum Scissors (short and long) 1 Brown Adson Large (multitooth) 1 Brown Adson Short (multitooth) Adson with Single Tooth 1 Crile Retractors (x 8) 4 Skin Hooks (2 Single, 2 Double) 2 #3 Knife Handles 1 Weitlander Self-Retainer (curved) 1 Long Hemostat 1 Pituitary Upbiter Heavy Mayo Scissors 1 Moynihan Instruments Needed for the Cadaver Lab: Rhinoplasty Instruments 1 Nasal Speculum (med, large) 1 Nasal Speculum (small) 1 Large Obwegeser Elevator 1 Freer Elevator 1 Turbinectomy Scissors 1 Double Action Rongeur