Did You Know: Reducing iatrogenic damage with IOM
Can you explain the role of an audiologist in intraoperative monitoring?As an audiologist in intraoperative monitoring, our responsibility is to provide functional information and identify changes that help guide surgeons during procedures to reduce iatrogenic damage to the nervous systems. We provide both preventative (warnings to the surgeon of potential injury and offering feedback simultaneously with surgical maneuvers) and interventional neuromonitoring (aiding in identification of critical structures).
Can you give us a list of the types of procedures where your specialty is required?
- Spinal fixation for scoliosis (adult and pediatric), tumor removals, degenerative disc diseases, and fractures.
- Craniotomies for brain tumor removals, biopsies, arteriovenous malformations, extra-intracranial bypass.
- Vascular surgeries such as carotid endarterectomies, abdominal aortic aneurysm, and thoracic endovascular aortic repair, transcarotid artery revascularization.
- Ear, nose, and throat surgeries such as mastoidectomies, thyroidectomies, and vocal cord paralysis cases.
- Peripheral hip and brachial plexus surgeries, sacroiliac joint fusions, microvascular decompression of the V and VII cranial nerves, tethered cord releases.
- We also have a special team that participates in deep brain stimulation surgeries.
I took a chance on myself. I had very little knowledge going into this, and just sent my resume to the company I currently work for. Shoutout to my Neurodynamics Inc. family. I completed a phone interview and then was able to schedule an in-person interview and observation, which allowed me to meet some of the team and get a better understanding of the job, all which furthered my decision to take the opportunity offered.
Was there a class in your audiology program that prepared you for your current role?
I think having a good foundation in evoked potentials helped me as far as understanding the testing modalities we utilize. I also was able to gain a concentration in interprofessional education which provided opportunities to learn, collaborate, and refine communication skills with other students gaining degrees in health professions.
Was there any additional credentialing or education you needed to obtain to hold the position you have?
With a doctorate in Audiology (AuD), ABRET (the credentialing organization for the field of neurodiagnostic technology) requires 150 cases with participation, and 30 hours of CEUs to be eligible to take the CNIM exam. The CNIM allows one to utilize the intraoperative equipment and our AuD allows us to interpret the data collected. Additionally, there is a board certification, BCS-IOM, one can obtain from the AABIOM (American Audiology Board of Intraoperative Monitoring), after an additional 250 cases.
What changes would you like to see in the healthcare community that could directly or indirectly improve life for your patients?
Wider integration of intraoperative monitoring and additional access to education and training for people interested in the field. The more skilled people that are doing NIOM the more patients and surgeons we can help.
What is one piece of advice that you would share with a current Au.D student or audiologist wanting to enter intraoperative monitoring?
- Make sure it is a good fit for you, observe if you can, watch some continuing education videos.
- If you end up at a company like mine that does trauma and surgeries other than ENT related ones, jump start your learning of anatomy.
- Look into fellowships or companies that will provide training
Dr. Blaise Pfaffmann is a dedicated neurophysiologist at Neurodynamics Inc. in San Diego, California where he provides intraoperative neuromonitoring (IONM) services across multiple hospitals in San Diego County. He earned his Bachelor’s degree from San Diego State University and his Doctorate in Audiology (AuD) with a concentration in intraprofessional education from Pacific University in Oregon. His academic journey has been marked by a commitment to both clinical excellence and collaborative learning, which he has actively pursued throughout his career.Before joining Neurodynamics Inc. in April 2023, he gained extensive experience in various audiology settings. He worked as a Pediatric Audiologist and Clinic Coordinator at a non-profit pediatric audiology clinic in Oregon. He then served as an Audiologist at Providence Speech and Hearing Center, partnering with the Children’s Hospital of Orange County.