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  • 1. 台灣顱底外科醫學會第四屆第一次會員大會暨學術研討會 地點:台北榮總致德樓第一會議室 (台北市石牌路二段 201 號) Scientific Program ( 97 年 11 月 15 日 星期六 ) 時間 議程 08:00~08:45 會員報到 08:45~09:00 潘宏基理事長 Opening remark 學術演講 座長 演講者 題目 9:00~9:20 曾漢民 鄭澄懋 Modified Orbitozygomatic Craniotomy for Medial Wing 魏志鵬 Meningiomas: cadaver dissection and report of five consecutive cases 9:20~10:00 杜永光 Professor Surgery for the Foramen Magnum Meningioma 顏玉樹 Hongo 09:50~10:00 discussion 10:00~10:30 施養性 杜永光 Surgical approaches to cavernous sinus lesions 邱仲慶 10:30~10:45 Coffee break 10:45~11:15 高明見 潘宏基 Gamma Knife Surgery for the treatment of cavernous sinus hemangioma and AV fistulas involving cavernous sinus 陳敏雄 11:15~11:35 張承能 侯勝博 Changing Paradigm in Skull Base Surgery- from open to endoscopic 關皚麗 11:35~11:55 洪純隆 沈炯祺 Neuroendoscopic history and future development 陳幸鴻 11:55~12:30 台灣顱底外科醫學會第四屆第一次會員大會暨理監事選舉 12:30~14:00 Lunch (中正一樓誠品生活廣場) (第三屆理監事:中正一樓蘇杭餐廳) 14:00-14:25 何青吟 張凱評 Identification of Macrophage Inflammatory Protein 3α as a Novel Serum Marker for Nasopharyngeal Carcinoma from cDNA microarray 14:25~14:50 邵國寧 李明陽 Skull base reconstruction with free ALP flap 許永信 14:50~15:15 黃勝雄 顏玉樹 Endoscopic transnasal transclival odontoidectomy 陳明德 15:15~15:40 陳翰容 劉安祥 Meningiomas of the craniovertebral junction 15:40~16:10 Coffee break(第四屆第一次理監事會議:選舉常務理監事及理事長 ) 16:10~16:30 蘇泉發 梁正隆 Gamma Knife Radiosurgery for skull base tumors 劉康渡 16:30~16:50 郭萬祐 駱子文 Gamma Knife Radiosurgery for Head and Neck Malignancy Invading Base of Skull – The Tzu-chi Experience 1
  • 2. 任森利 16:50~17:05 陳冠助 張軒凱 Multiple meningiomas of different pathologic types in a patient—a case report 黃文成 17:05~17:20 蔣永孝 楊懷哲 Trigeminal Neuralgia: Review of current treatment and our experience 17:20~17:35 鍾文裕 李政家 Vestibular evoked myogenic potential (VEMP) in radiosurgery-treated patients with acoustic neuromas 17:35~18:00 Shuttle bus to 僑園餐廳 18:00~ 晚宴 Modified Orbitozygomatic Craniotomy for Medial Wing Meningiomas: cadaver dissection and report of five consecutive cases 鄭澄懋 三軍總醫院 Abstract Medial wing meningiomas reside on the medial sphenoid ridge, which is a one-centimeter cliff-like bony structure where content of cavernous sinus, optic nerve, and cranial internal ceratoid artery are closely bounded to each other. Historically, these cranial base meningiomas were treated with traditional frontotemporal craniotomy and the outcome had not been promising largely because of the excessive brain retraction. Cranial base approaches with modern microneurosurgical techniques yield better results. However, these kind of cranial base approaches often cope with some extension of zygomatic arch, which associated with somewhat morbidity. We report the methods and results of using MOZC, without any resection of zygomatic arch, to access five consecutive large medial sphenoid wing meningiomas. The modified orbitozygomatic craniotomy (MORC) is a reform of skull base approach with the characteristics of its simplicity and wide exposure. Since this approach was newly introduced to the neurosurgical society lately in 2003, its clinical reports are few. The goal of this presentation is to advocate its clinical feasibility. In the following five years, five consecutive patients harboring large (> 4 cm) sphenoid wing meningiomas were treated with MORC. Total brain tumor removal was achieved in all patients. There is no mortality in this series of follow-up. One patient was complicated with the postoperative epidural hematoma and evacuated on the same operative day. All patients returned to their own daily activity without neurological sequella. The MORC is the option of choice in treating large upper-third clival lesion while the standard frontotemporal craniotomy is considered 2
  • 3. to give less surgical rooms. To our knowledge, this is the first report of treating sphenoid wing meningiomas with MOZC. 3
  • 4. Surgery for the foramen magnum meningioma Kazuhiro Hongo, Tetsuya Goto, Keiichi Sakai Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan Even with the recent advancement of the skull base approaches and techniques, surgery for the ventral foramen magnum remains challenging. To accomplish safe resection, microsurgical anatomy of this region should be fully understood. To achieve a satisfactory result for removing the ventral foramen magnum meningioma, adequate exposure with applying a skull base approach taken from the inferolateral side, and gentle manipulation to dissect the tumor from the surrounding critical structures without compressing the medulla oblongata are essential. The intraoperative electrophysiological monitoring is also quite helpful. In the presentation, key points for the surgical approach to this lesion as well as the anatomy of the foramen magnum are shown. Representative cases of meningioma surgery will be presented. 4
  • 5. 杜永光 尚缺 5
  • 6. Gamma Knife Surgery for the Treatment of Cavernous Sinus Hemangiomas and AV Fistulas Involving the Cavernous Sinus 潘宏基 David Hung-Chi Pan, M.D. 台北榮總神經外科 Department of Neurosurgery, Taipei Veterans General Hospital Introduction: Surgery for tumors or vascular lesions involving the cavernous sinus poses difficulty due to the risks of excessive bleeding. This report presents our 15-year experience in Gamma Knife surgery (GKS) for the treatment of cavernous sinus cavernous hemangiomas (CHs) and dural arteriovenous fistulas (DAVFs). The characteristic imaging findings of CHs, differential diagnosis from other benign tumors, radiosurgical methods, results and patients’ outcome are described. Material and methods: A total of 444 patients with cavernous sinus lesions were treated by GKS at the Taipei VGH between 1993 and 2008. Among them 265 were neoplasms and 179 were DAVFs. Cavernous sinus hemangiomas account for 2% (6 patients) of all tumors in the cavernous sinus. These rare but difficult tumors can be distinguished from more commom meningiomas based on the characteristic MR finding that T2-weighted images show marked hyperintensity. The median age of CH patients was 49y/o. Female was predominant with a male/female ratio of 2/4. Pre-treatment manifestations included headache, visual loss, oculomotor and abducence palsies. Tumor volume ranged 2.9-23.1ml. During radiosurgery, precise stereotactic targeting and irradiation using multiple small shots to obtain a conformal, high-dose treatment were achieved. Average marginal / maximum dose were 13/23 Gy respectively. For the 179 DAVF patients, GKS was applied to treat AV shunts involving the wall of the cavernous sinus. Feeders on the dural wall both from ICA and ECA were irradiated while optic nerves were carefully protected. After treatment, patients were regularly followed by MRI/MRA and doppler ultrasound to assess flow of the superior ophthalmic veins. Cerebral angiography was performed 2 years post-treatment to verify complete obliteration. Results: Five of six cases with CHs had received regular MRI follow-up study (FU range 6-156, mean 40 months). Clinically, all patients showed remarkable symptomatic improvement with resolution of headache, diplopia or visual impairment. There was no complication or mortality. Tumor volume measurement in follow-up MRI showed 80% reduction of the volume, with rapid regression of the tumor within 3-6 months. For comparison, the average volume change of our 84 meningiomas only showed 29% reduction. The statistical difference of volume changes between CHs and meningiomas was significant (p=0.0023). For the DAVF patients, 90% showed clinical improvement with disappearance of red eyes, chemosis, or double vision. Follow-up in 105 patients based on Kaplan-Meier study showed 70% cure rate in the first year and 90% in the second year. There was 6% with persisted symptoms or recurrence 2 years post-treatment. Conclusion: GKS is a safe and effective alternative treatment for cavernous sinus hemangiomas and 6
  • 7. dural AV fistulas. The characteristic MRI findings of CH before and after GKS allow us to select proper cases for the treatment. 7
  • 8. Changing Paradigm in Skull Base Surgery- from open to endoscopic Sheng-Po Hao MD, FACS, FICS Professor & Chairmen, Department of Otolaryngology Head and Neck Chang Gung Memorial Hospital Chang Gung University Surgical approach is the cornerstone of a successful skull base surgery. For the anterior cranial base lesions, craniofacial resection is the standard approach. However, with the modern development of endoscope and vast advance of technology in navigation system, an open wide field approach which usually carries unavoidable morbidity is no longer always considered feasible. Rather, endoscopic approach, endoscopic resection and encoscopic reconstruction seems justified if the oncological results is not inferior to open method. However, we have to keep in mind that the only thing changed in endoscopic resection is the way to remove the tumor, nevertheless, the extent of resection and the control of surgical margin remain exactly the same with the open method. Thus, we may reach the same oncological results but having fewer surgical morbidity. The future trend is to change the paradigm in skull base surgery from open to endoscopic. 8
  • 9. 沈炯祺 尚缺 9
  • 10. Identification of Macrophage Inflammatory Protein 3α as a Novel Serum Marker for Nasopharyngeal Carcinoma from cDNA microarray Kai-Ping Chang, M.D., Ph.D.; Ku-Hao, Fang, M.D.; Sheng-Po Hao, M.D., FACS 張凱評, 方谷豪, 侯勝博 Department of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Lin-Kou Medical Center, Tao-Yuan, Taiwan 長庚紀念醫院林口醫學中心耳鼻喉部頭頸外科 Introduction: From differential expression profiles analyzed using cDNA microarray between paired nasopharyngeal carcinoma (NPC) and pericancerous normal epithelium, we identified two sets of genes which were up-regulated/ down-regulated in NPC tumors and associated with immune response. Among these genes, we found the most up-regulated gene, macrophage inflammatory protein (MIP)-3α might be a potentially novel tumor marker. We herein examine whether MIP-3α is a biomarker for NPC, and whether it is involved in modulating NPC cell functions. Materials & Methods: The study population comprises 275 NPC patients and 250 controls. MIP-3α levels in tissues and sera were examined by immunohistochemistry and ELISA, respectively. EBV DNA load and EBV VCA IgA were measured by qRT-PCR and immunofluorescent assay, respectively. MTT assays were done to investigate the role of MIP-3α on NPC cell proliferation. Effects of MIP-3α on NPC cell motility were investigated by trans-well migration/invasion assays and RNA interference. Results: MIP-3 α was over-expressed in NPC tumor cells. Serum MIP-3α levels were significantly higher in untreated patients, recurrent patients and patients with distant metastases versus non-NPC controls, patients with complete remission, and long-term disease-free patients. In the prospective cohort, serum MIP-3α levels were significantly higher in untreated NPC patients with advanced TNM stage versus early stage, and also correlated with EBV DNA load. Measurement of MIP-3α, EBV DNA and VCA IgA levels in serial serum/plasma samples from treated patients at 6-month intervals revealed a high association between MIP-3α level, EBV DNA load and disease status. Among 155 consecutive NPC patients, subjects with pre-treated MIP-3α serum levels over 65 pg/ml had worse prognoses for overall survival and distant metastasis-free survival in univariate and multivariate analysis. Additionally, cell functional assays showed that MIP-3α had no obvious effect in the NPC cell proliferation but contributed to migration and invasion of NPC cells, which could be effectively inhibited by MIP-3α knock-down. Conclusions: From the analysis derived from the results of cDNA microarray, we discovered the up- regulation of MIP-3α and found that MIP-3α may be a novel biomarker and prognosticator for NPC and is involved in migration and invasion of NPC cells. Anterior Skull Base Reconstruction with Free Anterolateral Thigh Flap – NCKUH Experience 前側大腿皮瓣重建顱底缺損:成大醫院之經驗 Ming-Yang Lee E-Jian Lee 10
  • 11. Division of Neurosurgery, Department of Surgery, National Cheng- Kung University Hospital 李明陽 李宜堅 成大醫院神經外科 Summary Defects at the anterior skull base were not commonly found after head trauma and skull base tumor resection. Reconstruction of the anterior skull base defect is paramount to prevent postoperative complications such as cerebrospinal fluid (CSF) leakage and meningitis ascending infection from underlying aerodigestive tract. Several reconstructive methods of the anterior skull base have been reported . From February 2004 to July 2008 the anterior skull base reconstructions were performed in 17 patients. In 9 patients the defects were related to the head and neck tumors and 8 patients related to the severe head trauma with comminuted fractures in the anterior cranial base. Reconstructions with galeopericranial flaps were used in fifteen patients and free anterolateral thigh (ALT) flap were performed in two patients due to large head and neck defect and reoperation. There were no CSF leakage and postoperative meningitis. By a multidisciplinary surgical team approach, there is an increasing role for reconstruction of complex anterior cranial base resection defects using microvascular surgical techniques. 11
  • 12. Endoscopic Trans-nasal Trans-clival Odontoidectomy: A New Approach to Decompression Jau-Ching Wu, M.D.1,2,3,4, Wen-Cheng Huang, M.D.1,2,3, Henrich Cheng, M.D., Ph.D.1,2,3,4 , Mu-Li Liang, M.D.1,3, Ching-Yin Ho, M.D., Ph.D.3,5, Yang-Hsin Shih, M.D.1,3, Yu-Shu Yen M.D.1,3 Objectives: Endoscopic trans-nasal trans-clival resection of the odontoid process is less invasive than the standard trans-oral odontoidectomy. We describe here our techniques that are less invasive but provided successful decompression. Presentations: From September 2004 to April 2007, three consecutive patients with basilar invagination and instability in the cranio-vertebral junction were enrolled in this report. The etiologies included rheumatoid arthritis in two and trauma in one, and all presented with myelopathy and quadriparesis prior to the interventions. Interventions: All of the three patients underwent an endoscopic trans-nasal trans-clival approach for anterior decompression and resection of the displaced odontoid process and pannus, in order to decompress the underlying medulla. Subsequently, they received occipital-cervical fixation by lateral mass screws and bone fusion to ensure stability. Remarkable neurologic recovery was observed after surgery in all and no adverse effects were noted. Conclusions: Compared to the standard trans-oral approach, the trans-nasal trans-clival endoscopic approach for decompressing basilar invagination is a feasible and effective alternative that avoids common disadvantages like prolonged intubation, excessive tongue retraction, and need for palatal incision. 12
  • 13. Meningiomas of the craniovertebral junction Ann-Shung Lieu, Shiuh-Lin Hwang and Shen-Long Howng 顱脊椎處腦膜瘤 劉安祥 黃旭霖 洪純隆 Department of Neurosurgery, Kaohsiung Medical University Hospital 高雄醫學大學附設醫院 神經外科 Tumors of the foramen magnum are found infrequently and, due to their insidious onset, they resemble degeneration diseases of the central nervous system. Meningiomas are the most common benign tumors of the foramen magnum. They represent about 1.8% of all meningiomas. Most of these lesions can be resected using traditional posterior approaches, but some anterior and anterolateral lesions are difficult to be resected via traditional methods due to inadequate exposure. Therefore, management of lesions situated in the anterior foramen magnum, lower livus, and anterior aspect of the upper cervical area is a challenging issue for neurosurgeon. Mehtods of treating these lesion includes transoral, transuncodiscal, and lateral suboccipital approaches, the last of which has undergone several modifications including the for-lateral suboccipital, dorsolateral suboccipital transcondylar, and extreme lateral transcondylar variations. Lateral suboccipital approaches and modificational exposure can be satisfactory with minimal or no retraction of important neurovascular structures in the region. 13
  • 14. Gamma Knife Radiosurgery for Skull Base Tumors Cheng-Loong Liang, Kang Lu, Han-Jung Chen Department of Neurosurgery, E-Da Hospital, I-Shou University, Kaohsiung Tumors located at the skull base are among the most difficult problems that neurosurgeons encounter. Management of patients with skull base tumors must take into account that complete tumor removal is not possible with acceptable morbidity in many patients. Therefore, radiation therapy and stereotactic radiosurgery (SRS) are commonly performed. The use of radiosurgery for patients with skull base tumors has increased significantly over the past two decades. The goal of radiosurgery is cessation of tumor growth and preservation of neurological function. The technique of radiosurgery has evolved due to improved imaging, better radiosurgical devices and software, and the continued analysis of results. In this report, the authors discuss technical concepts and present the preliminary results of skull base radiosurgery treated by Gamma knife in E-Da hospital. At our center we used Gamma Knife SRS for a variety of benign, extraaxial basal tumors. These included schwannomas, meningiomas, hemangiomas, pituitary adenomas, craniopharyngiomas. For properly selected patients with benign tumors (meningiomas, schwannomas, glomus tumors), tumor control rates between 90 and 100% have been reported. Radiosurgery is also commonly performed for patients with malignant skull base tumors as a palliative treatment and symptom relief is common, especially for patients with cranial nerve involvement related to their tumor. 14
  • 15. Gamma Knife Radiosurgery for Head and Neck Malignancy Invading Base of Skull – The Tzu-chi Experience Tzu-wen Loh1, Tsung-lang Chiou1, Pao-sheng Yen2, Dai-wei Liu3, Peir-rong Chen4, Chain-fa Su1 駱子文 1, 邱琮朗 1, 嚴寶勝 2, 劉岱瑋 3, 陳培榕 4, 蘇泉發 1 Department of Neurosurgery1, Department of Radiology2, Department of Radiation-Oncology3, Department of Otolaryngology4, Buddhist Tzu-Chi Medical Center, Hualien, Taiwan, R.O.C. 花蓮慈濟醫學中心 神經外科 1, 影像醫學科 2, 放射腫瘤科 3, 耳鼻喉科 4 Introduction: Although less common, local invasion of head and neck malignancy into skull base might be disclosed. This kind of extension remains challenging to skull base surgeons because of vulnerability of nearby vital neurological strutures. Fortunately, lots of head and neck malignancy are radio-sensitive. Thus, Gamma knife radiosurgery might hold an evolving position in treatment of extensive skull base invasion of head and neck malignancy. Materials & Methods: From November 2003 to August 2008, 10 patients with local skull base invasion of head and neck malignancy were referred from our otolaryngology department. Before referral, operations for radical excision were all applied to these patients. There were 3 women and 7 men in this group, and the mean age was 46.7 years old. The entities of disease diagnosis included NPC in 3, buccal cancer in 2, hypopharyngeal cancer in 2, parotid gland tumor in 1, and salivary gland neoplasm in 1 patient, and another patient suffered from olfactory neuroblastoma. The mean tumor volume of skull base extension was 12.8 c.c. (range: 8.8 to 36.8 c.c.). Gamma knife radiosurgery was arranged to these patients and the mean prescription dosage was 18.6 Gy (range: 18 to 20 Gy). Some extensive tumor masses were so close to optic apparatus that dosage of 8 Gy was adapted as safe upper limit of irradiation within the optic apparatus. Results: The follow-up periods in these patients were 11 to 28 months. 5 patients encountered mortality during follow-up due to primary disease progression. No marked neurological deficits were noted within these patients. Conclusions: From our preliminary experiences, Gamma knife radiosurgery might be a safe and useful tool when dealing with local skull base invasion of head and neck malignancy. It might also be put into consideration of co-operation between otolaryngologists and neurosurgeons, especially when the skull base extension was around cavernous sinus, optic apparatus, or other important but vulnerable structures. The long-term follow-up and evaluation is, nevertheless, still in necessity. 15
  • 16. Multiple meningiomas of different pathologic types in a patient: a case report Hsuan-Kan Chang, MD Li-Yu Fay, MD Chun-Fu Lin, MD Min-Hsiung Chen, MD, PhD 張軒侃, 費立宇, 林俊甫, 陳敏雄 Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C. 台北榮總神經醫學中心神經外科 Abstract: Multiple meningiomas(MM) are considered rare disease entity, which accounts for 5.9-10.9% of all meningiomas from literature review. Most MM removed from the same person showed identical pathological subtype. The authors report a case of multiple meningiomas with different pathologic subtypes. The patient is a 67-years-old female with the initial presentation of right eye ptosis. MRI revealed four spatially separated meningiomas located at right parasagittal, bilateral cavernous sinuses, and left planum sphenoidale, respectively. The surgeons removed three of them in one operation and pathology showed three different subtypes of meningiomas, namely meningothelial, fibrous, and secretory types. Special immunohistochemistry such as progesterone receptor(PR), p53, and MIB-1 LI were performed and compared with literature results. 16
  • 17. Trigeminal Neuralgia: Review of current treatment and our experience 楊懷哲 劉康渡 鐘文裕 潘宏基 台北榮總神經外科 Trigeminal neuralgia (TN) is the most common facial neuralgia, and is considered to be one of the most painful conditions to affect patients. TN is generally characterized by lancinating, unilateral, paroxysmal pain occurring in the distribution of the fifth cranial nerve. Generally, TN can be diagnosed by the typical patient history, a negative neurologic exam, and response to a trial of carbamazepine. Imaging studies should be considered if the diagnosis is uncertain or neurologic abnormalities are noted. Most cases are caused by compression of the trigeminal nerve root, usually within a few millimeters of entry into the pons. The treatment modalities for the management of TN may be divided into medical, surgical, and gamma-knife radiosurgery. Generally, response to drug therapy is good, with over 80% of patients responding to some of the anticonvulsants. Percutaneous approaches to trigeminal gangliolysis are considered to have less associated risk and less cost than open surgical procedures. Open surgical procedures used in the treatment of TN include microvascular decompression of the trigeminal root and retrogasserian rhizotomy. Additionally, because both of these procedures have greater associated risks, morbidity, and mortality, they are customarily applied only to younger patients in good health. Stereotactic radiosurgery has been established as an alternative treatment for patients who do not respond to optimal medical management. We began use of this technique at our center in 1995 and have evaluated outcomes serially. Independently acquired data from 207 patients with idiopathic TN that had Gamma Knife radiosurgery was reviewed. 29 patients received twice Gamma-kinfe treatment and 2 patients received three times due to recurrent pain.The maximal radiosurgery dose was 80 Gy with a range of 70 to 90 Gy. One hundred patients (48.3%) had prior surgery or radiofrequency treatment. Patients were followed to a maximum of 10.5 years (mean, 28 months). Complete or partial pain relief was achieved in 58.5% of patients at 1 year. The absence of prior surgery correlated with an increased proportion of patients in complete or partial pain relief over time (65.4%). 5.8% of patients developed new or increased subjective facial paresthesia or facial numbness. Radiosurgery for idiopathic TN was safe and effective and is an important addition to the surgical armamentarium for TN. 17
  • 18. Vestibular evoked myogenic potential (VEMP) in acoustic neuromas treated by Gamma-knife radiosurgery --- preliminary study 聽神經瘤經伽馬刀治療後之前庭誘發肌性電位---初步研究 李政家 楊懷哲 劉康渡 鍾文裕 潘宏基 王懋哲 蕭安穗 台北榮民總醫院 神經外科 耳鼻喉科 Introduction The ventricular evoked myogenic potential (VEMP) test showed abnormal results in 80% of acoustic neuroma (AN). Although the sensitivity of VEMP was lower than that of ABR test, it is useful in neurophysiology to classify the origin of ANs. Besides, pure tone audiogram (PTA) and Calori test give us additional information to differentiate the nature of ANs. In this preliminary study, we hope to study the VEMP in ANs treated by Gamma-knife radiosurgery. Patients and methods Ten AN patients was recruited, and we performed PTA, Calori test, and VEMP. We defined 30dB loss as abnormal PTA finding, canal paralysis (Jonkees’ formula) > 20% as abnormal Calori test, and evoked potential ratio (EPr) >30% as abnormal VEMP results. We also calculate the volume of tumors, to correlate the results of PTA, Calori, and VEMP test. Finally, compare pre-GKS and post-GKS VEMP (EPr) results. Results The PTA, Calori test , and VEMP test showed abnormal results in 80%, 60% and 60% ANs, respectively. Hearing impairment, tinnitus, and dizziness were happened in 90%, 70%, 60% ANs, respectively. PTA, Calori test, and VEMP results were not correlated each other. The larger tumor, the more severe results in PTA, Calori test, and EPr were found. The tumor volume can be calculated = -0.875 + 1.040*(PTA) + 2.350*(Calori test) + 2.175*EPr. Finally, all tests (PTA, Calori test, and VEMP) are progressing in first month followed-up after Gamma knife radiosurgery. Discussion All three tests can help use to differentiate the nature of tumors. The three tests are independent in the small volume of tumor, although all tests are abnormal in large volume of tumor. Our followed-up post radiosurgery still in proceed, and need more time to observe the outcome of the ventricular functional recover. ********************************************************************************* 18
  • 19. 9:00~9:20 Name: 鄭澄懋 Cheng-Mao Cheng (Also known as: Robert C.M. Cheng) Professional Address: Division of Neurological Surgery Tri-Service General Hospital, e-mail: Date of Birth: 18 August, 1964 Education: 1990 Bachelor of Medicine National Defense Medical Center, Taipei, Taiwan Speical Training: 1988- 1990 Medical Internship Tri-Service General Hospital, Taipei, Taiwan 1992- 1994 General Surgery Tri-Service General Hospital, Taipei, Taiwan 1994.1997 Neurological Surgery Residency Tri-Service General Hospital, Taipei, Taiwan 1997.1998 Neurological Surgery Chief Resident Tri-Service General Hospital, Taipei, Taiwan 1998.1999 Visiting doctor of Neurological Surgery, Pen-Hoo Army Hospital, Pen-Hoo, Taiwan 1999.2000 Attending doctor of Neurological Surgery, Tri-Service General Hospital, Taipei, Taiwan 2001-2002 Reaserch fellowsip in skull base surgery and neuroradiology in Oregon Health & Science University 2002.2007 Attending doctor of Neurological Surgery, Tri-Service General Hospital, Taipei, Taiwan Activity: Member of Surgical Association, Republic of China Member of Neurosurgical society, Taiwan Interests: Mountain climbing, fishing, photography. 19
  • 20. Research Experience: 1. Skull base Surgery 2. Spinal cord repair on rat Division of Neurological Surgery Tri-Service General Hospital Advisor: Shinn-Zong Lin, Ph.D. Presentation: 1. Cheng-Mao Cheng, Shinn-Zong Lin, Yung-Hsiao Chiang, Ming-Ying Liu: Correlation of monitoring of laser Doppler flowmetry and intracranial pressure in severe head- injuried patients: a preliminary result in Tri-Service General Hospital Annual meeting of Surgical Society,R.O.C., 1998 Presented by Cheng-Mao Cheng 2. Cheng-Mao Cheng, Shinn-Zong Lin, Yung-Hsiao Chiang, Ming-Ying Liu: Intracranial pressure monitoring in severe head-injured patients: a practical method in delineation of adequate cerebral perfusion pressure and the preliminary result in Tri-Service General Hospital. 11th Internaional Congress of Neurological Surgery, July 1997 Presented by Cheng-Mao Cheng 3. Cheng-Mao Cheng, Shinn-Zong Lin, Yung-Hsiao Chiang, Ming-Ying Liu: The application of the stereotactiv craniotomy with removal of tumor under laser guide Annual meeting of Surgical Society,R.O.C., 1997 Presented by Cheng-Mao Cheng 4 Cheng-Mao Cheng, Rochey Chao, Shinn-Zong Lin, Ming-Ying Liu: Posterior atlantoaxial interarticular screw fixation as an alternative option for treatment of type II Odontoid Fracture complicated by failure of anterior odontoid screw fixation—a case report Annual meeting of Surgical Society, R.O.C., 1996 Presented by Cheng-Mao Cheng 5. Cheng-Mao Cheng, Gregory J Anderson, Frank Hsu, Akio Noguchi, Aclan Dogan, Sean O McMenomey: Quantitative comparison of the supraorbital keyhole, pterional and supraorbital subfrontal approaches to the parasellar region Annual Meeting of North America Skull Base Society, California, USA, 2002 Presented by Cheng-Mao Cheng 20
  • 21. 6. Cheng-Mao Cheng, Frank Hsu, Akio Noguchi, Aclan Dogan, Sean O McMenomey, Johnny B Delashaw: Topography of skull base in relation to fisher’s segmental nomenclature of intracerebral artery Annual Meeting of North America Skull Base Society, California, USA, 2002 Presented by Cheng-Mao Cheng Publication: 1. Cheng-Mao Cheng, Ming-Ying Liu, Bao-Chiien Chang, Cheng-Ti Cheng. Detection of radiation necrosis with Thallium-201 and Technetium-99m DTPA single-photon emission computed tomography in a patient with irradiated malignant glioma. Annal of Nuclear Medicine and Sciences.Vol. 10, No. 1, 5-8, 1997 2. Cheng CM, Chiang YH, Fan YM, Huang WS, Cheng CY. Localization of Abscess in Dural Graft with Fusion Image of Gallium-67 CT-SPECT. 核子醫誌 17:225-228, 2004 3. Cheng CM, Alpha fetoprotein producing immature teratoma of the pinel region without components of endodermal sinus tumour. J of Clin Neuroscience 13: 257-259, 2006 4. Vijayabalan Balasingam , Gregory J Anderson , Neil D Gross , Cheng-Mao Cheng , Akio Noguchi , Aclan Dogan , Sean O McMenomey , Johnny B Delashaw Jr , Peter E Andersen. Anatomical analysis of transoral surgical approaches to the clivus. J Neurosurg. 2006 Aug ;105 (2):301-8 21
  • 22. 9:20~10:00 Name: Kazuhiro Hongo, M.D., Ph.D. Address (office): Professor and Chairman Department of Neurosurgery Shinshu University School of Medicine 3-1-1 Asahi, Matsumoto 390-8621, Japan Tel : +81-263-37-2690, Fax: +81-263-37-0480 E-mail: Date of Birth: December 10, 1953 Citizenship: Japanese Medical School: Shinshu University School of Medicine (April, 1974 - March, 1978) Postgraduate Training & Professional Career: 1978 Junior Resident, Dept. of Neurosurgery, Shinshu Univ. School of Medicine 1979 Rotating Intern, Anesthesiology, Shinshu Univ. School of Medicine 1980 Fellow in Pharmacology, Shinshu Univ. School of Medicine 1981 Chief, Dept. of Neurosurgery, Matsumoto National Hospital 1982 Chief, Dept. of Neurosurgery, Shinonoi General Hospital 1984 Staff, Dept. of Neurosurgery, Shinshu Univ. School of Medicine 1986 Research Fellow, Dr. Kassell’s Cerebrovascular Research Laboratory, Dept. of Neurosurgery, University of Virginia, USA 1988 Chief, Dept. of Neurosurgery, Showa-Inan General Hospital 1992 Assistant Professor, Dept. of Neurosurgery, Shinshu Univ. School of Medicine 1994 Associate Professor, Dept. of Neurological Surgery, Aichi Medical University 2001 Associate Professor, Dept. of Neurosurgery, Shinshu Univ. School of Medicine 2003 Professor and Chairman, Dept. of Neurosurgery, Shinshu Univ. School of Medicine Fields of Research and Academic Interest: Microsurgery of cerebrovascular diseases (AVM, aneurysm), Skull base surgery (meningioma, neurinoma, etc.) Microvascular decompression Robotics surgery Pharmacological research on cerebral vasospasm 22
  • 23. 10:00~10:30 Yong-Kwang Tu, M.D.,Ph.D. Birth Date: April 9, 1948 Marital Status: Married with 2 children (Spouse: Tso-Hsien Tu) Current position: Professor and Chairman, Department of Neurosurgery, College of Medicine and Hospitals, National Taiwan University, Taipei, Taiwan Medical education: 1976 M.D. School of Medicine, National Taiwan University, Taipei 1984 Ph.D. Institute of Clinical Medicine, National Taiwan University, Taipei Postdoctoral training: 1976-1977 Resident in Internal Medicine National Taiwan University Hospital, Taipei 1977-1980 Resident in Surgery (Neurosurgery) National Taiwan University Hospital, Taipei 1980-1981 Chief Resident in Neurosurgery National Taiwan University Hospital, Taipei 1984.1988 Fellow in Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, U.S.A. Academic Appointments 1987.1988 Instructor in Surgery (Neurosurgery), Harvard Medical School, Boston, U.S.A. 1989.1991 Associate Professor in Neurosurgery (Non-tenure), National Taiwan University 1991.1998 Associate Professor in Neurosurgery (Tenure), National Taiwan University 1998- Present Professor in Neurosurgery (Tenure), National Taiwan University 2004- Present Chairman, Department of Neurosurgery, National Taiwan University Other Appointments: 1982-1983 Chief, Department of Neurosurgery, King Fahd Hospital (Jeddah General Hospital), Kingdom of Saudi Arabia 23
  • 24. 1998.1999 Vice-President, Provincial Taoyuan Hospital, Taoyuan, Taiwan 1999-2000 President, Municipal Chung-Hsin Hospital of Taipei 2000-2001 Director, Taipei Stroke Center Academic Societies: 2000-2002 Secretary General, International College of Surgeons 2001-2003 President, Taiwan Stroke Society 2001-2004 President, Asian-Oceanian Society for Skull Base Surgery 2003-2005 President, Taiwan Society for Skull Base Surgery 2005-2007 President, Taiwan Neurosurgical Society 2006-2009 President, International Congress on Cerebrovascular Surgery 2007-2011 President, Asian-Australasian Society of Neurological Surgeons 2009-2012 Second Vice President, World Federation of Neurosurgical Societies 24
  • 25. 10:45~11:15 Name: David Hung-Chi Pan, M.D. Birth Date: Nov. 9, 1947, Male, Birth Place: Taiwan Present Position: (1) Director, Gamma Knife Center, Neurological Institute, Taipei Veterans General Hospital, 1993 till now (2) Chief, Division of Functional Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, 1989 till now (3) Professor of Surgery, Faculty of Medicine, National Yang-Ming University, 2003 till now (4) Delegate, Radiosurgery Committee, World Federation of Neurological Surgery (WFNS). (5) President, Taiwan Society for Skull Base Surgery, 2007-2008 Experience: (1) Resident, Department of Surgery, Taipei Veterans General Hospital, 1974-1977 (2) Attending Neurosurgeon, Neurological Institute, Taipei Veterans General Hospital, 1979-1989 (3) Clinical Fellow, Department of Neurosurgery, Karolinska Hospital, Sweden, 1981-1982 (4) Associate Professor, Faculty of Medicine, National Yang-Ming University, 1985 – 2003 Education: (1) Taipei Medical University, Taipei, Taiwan, 1966-1973 (2) Karolinska Institute, Stockholm, Sweden, 1981-1982 Society Membership: (1) World Society for Stereotactic and Functional Neurosurgery since 1989 (2) International Stereotactic Radiosurgery Society since 1992 (3) Leksell Gamma Knife Society since 1992 (4) World Federation of Neurological Surgery, Radiosurgical Committee since 1995 25
  • 26. (5) Taiwan Neurosurgical Society since 1993 (6) Chinese Medical Association (Taipei) since 1974 (7) Surgical Association, Taiwan since 1974 26
  • 27. 11:15~11:35 1、 基本資料                簽 名:       HAO SHENG-PO 中文姓名 侯勝博 英 文 姓 名 (Last Name) (First Name) (Middle Name) 國 籍 中華民國 性 別 男 □ 女 出生日期 1959 年 06 月 30 日 聯 絡 電 話 (公).03-3281200 EXT 3966 (宅).02-27602407 傳 真 號 碼 03-3979361 E-MAIL 2、主要學歷 請填學士級以上之學歷或其他最高學歷均可,若仍在學者,請在學位欄填「肄業」。 畢/肄業學校 國別 主修學門系所 學位 起訖年月(西元年/月) 台北醫學院 中華民國 醫學系 醫學士 1978/ 09 至 1985/ 07   / 至  /    / 至  /  3、現職及與專長相關之經歷 指與研究相關之專任職務,請依任職之時間先後順序由最近者 往前追溯。 服務機關 服務部門/系所 職稱 起訖年月(西元年/月) 現職:   / 財團法人長庚紀念醫院 耳鼻喉部 副教授 2005/07 至今 部長 經歷:   / 至  /  孫逸仙癌症中心 耳鼻喉科、頭頸外科 主任 1995/ 07 至 1997/07 財團法人長庚紀念醫院 耳鼻喉科 主治醫師 1989/ 07 至 1995/06 美國 Cornell University Memorial Sloan-Kettering 研究員 1993/ 06 至 1993/06 Cancer center 美國匹茲堡大學 耳鼻喉、頭頸外科及顱底醫 研究員 1992/ 09 至 1993/06 學中心 四、專長 請自行填寫與研究方向有關之學門及次領域名稱。 鼻咽癌 口腔癌 顱底手術 頭頸部腫瘤 27
  • 28. 11:35~11:55 姓 名: 沈炯祺 Chiung-Chyi Shen 性 別:男 出生日期 : 1961年2月18日 學 歷 : 國防醫學院80期畢業(76年班) 職 稱 : 台中榮總神經外科 主任 國立陽明醫學大學專任助理教授 國立國防醫學大學兼任助理教授 教師資歷 : 助教授字第007871號 (教育部) 求學及經歷 76年 畢業(大字第027214號)後分發至台中榮總擔任住院醫師,接受 神經外科專科醫師訓練,並通過醫師執照考試(醫字第015879號) 80年 升任神經外科住院總醫師 80年 通過外科專科醫師考試 (外專醫字第2709號) 81年 升任神經外科主治醫師 81年 獲選為台中榮民總醫院臨床教學績優醫師 82年 通過神經外科專科醫師考試 (神外專字第000257號) 82年 轉任台中空軍總醫院神經外科主任醫師 83年 借調嘉義榮民醫院神經外科主治醫師 84年 通過公務人員高等考試(全高字第3293號) 87年 獲選台中市優良醫師特殊貢獻獎 28
  • 29. 87年 於中國醫藥學院醫學系授課 88年 上學期於中國醫藥學院醫學系授課 88.08 ~ 89.07赴美國哈佛大學附設醫院 麻省總醫院神經外科進修 89年 回國擔任神經外科主治醫師 90年至今於弘光科技大學授課 92年 於中山醫科大學醫學系授課 92年 於國立暨南大學生命科學研究所授課 93年 台中榮總神經外科主任 29
  • 30. 14:00-14:25 張凱評醫師 Kai-Ping Chang, MD, PhD 學歷: 長庚大學醫學系醫學士 長庚大學醫學博士 美國醫師資格 ECFMG 證書 經歷: 長庚醫院林口醫學中心耳鼻喉部總醫師 台灣耳鼻喉專科醫師 台灣臨床腫瘤專科醫師 台灣顱底外科醫學會創始會員 現任: 長庚醫院耳鼻喉部頭頸腫瘤外科主治醫師     長庚大學醫學系助理教授 台灣頭頸部腫瘤醫學會理事 美國耳鼻喉頭頸外科學會會員 美國癌症研究協會會員     專長: 口腔癌手術    鼻咽癌治療  喉癌,下咽癌外科治療     頭頸部腫瘤外科 頭頸癌分子醫學研究 一般耳鼻喉科 30
  • 31. 14:25~14:50 姓 名:(中文) 李明陽 (個人照片) Name: (英文 ) Ming-Yang Lee 職 稱:□ Professor □ Associate professor ■ Assistant professor □ Lecturer ■醫師 _□ Others________ 單 位:(中文) 國立成功大學醫學院附設醫院外科部神經外科 (英文 ): Department of Surgery, National Cheng-Kung University Hospital Appointments(現職):Clinical Assistant Professor in Surgery (Neurosurgery), National Cheng Kung University Medical School. Address : Neurosurgical Service, Department of Surgery (Neurosurgery), National Cheng Kung University Medical Center and Medical School. 138 Shen-Li Road, Tainan, Taiwan. E-mail: TEL:06- 235-3535 ext 5181 FAX:06- 276-6676 Education (學位): Ph.D. candidate: Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan. Professional activities (經歷) • Fellowship in Neurological & Neurosurgical Departments, University of Massachusetts Medical School, Worcester, MA, USA • Fellowship in Neurosurgical Departments, Brigham & Women Hospital, Boston, MA, USA Research Interest (研究興趣): 1. Biomechanics of Spine 2. Neurooncology 3. Cerebral blood flow and metabolism 31
  • 32. 14:50~15:15 Name: Yu-Shu Yen ( 顏玉樹 ) Date of Birth: October 10, 1962 Sex: Male Birthplace: Chya-Yi, Taiwan, R.O.C. (中華民國,台灣,嘉義縣) Citizenship: Taiwan, Republic of China Family: Married, one son and one daughter Office Address: Department of Neurosurgery, Neurological Institute, Veterans General Hospital-Taipei No. 201, Sec 2, Shih-Pai Road, Shih-Pai, Taipei, Taiwan 112 Republic of China Telephone: (O) 886-2-8757491 ext. 9, 886-2-8712121 ext. 3147 Fax No.: (O) 886-2-8757588 Education: 7/1981 - 6/1988 Medical Department of China Medical College, Taichung, Taiwan Internship: Chang-Gung Memorial Hospital, Lin-Cou, Taipei, Taiwan (July 1986 - June 1988) Postgraduate Training: 7/1988 - 6/1990 Rotating Surgical Resident Department of Surgery, Chang-Gung Memorial Hospital, Lin-Cou, Tao-Yuan 7/1990 -6/1993 Neurosurgical Resident Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital 7/1993 -6/1994 Chief Resident in Neurosurgery Department of Neurpsurgery, Neurological Institute, Taipei Veterans General Hospital 7/1996 – 6/1997 Research fellow in Neurosurgical and Pharmacology Departments, Shinshu University School of Medicine, Matsumoto, Japan 32
  • 33. Hospital Appointments: Since Feb. 1995 Attending Neurosurgeon Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital Academic Appointments: Since July 1993 Lecturer of Neurology and Neurosurgery National Defense Medical College, Taipei, Taiwan, R.O.C. Since July 1993 Lecturer of Surgery National Yang-Ming Medical College, Taipei, Taiwan,R.O.C. Present Clinical Assistant Professor of Neurosurgery National Defense Medical College, Taipei, Taiwan, R.O.C. Present Clinical Assistant Professor of Neurosurgery National Yang-Ming University, School of Medicine Membership in Academic and Professional Organization: Member of Surgical Association, Republic of China Member of Neurological Society, Republic of China (Taiwan) Member of Neurosurgical Association, R.O.C. (Taiwan) Member of Taiwan Neurospinal Society Member of Taiwan Neurooncology Society Member of Taiwan Skull Base Society Member of Taiwan Endoscope Society Member of Taiwan Stroke Society Organization of National Academic Society July 2001 ~ June 2003 Vice Secretary General of Taiwan Neurospinal Society Dec 2001 ~ Nov 2003 Vice Secretary General of Neurosurgical Association, R.O.C. (Taiwan) March 2003 ~ Feb 2005 Secretary General of Taiwan Stroke Society Dec 2003 ~ Nov 2005 Secretary General of Taiwan Neurooncology Society March 2005 ~ Board of directors of Taiwan Stroke Society Organization of International Conferences/Symposia Secretary General of the 4th Meeting of the Asian Society for Neuro-Oncology, Taipei (Grand Hotel), Taiwan, November 4 ~ 6, 2005 Secretary General of 34th Annual Meeting of the International Society for Pediatric Neurosurgery (ISPN), Taipei(Grand Hotel), Taiwan, September 10 ~ 14, 2006 33
  • 34. 15:15~15:40 一、基本資料 Lieu Ann Shung 中文姓名 劉安祥 英文姓名 性別 男 出生年月日 51 年 8 月 21 日 E-mail 二、主要學歷 畢業學校 國別 主修學們系所 學位 起訖年月 1981/09~1988/06 高雄學大學 中華民國 醫學系 學士 三、現職及專長 服務機關 服務部門 職稱 起訖年月 現職: 高雄醫學大學附設醫院 神經外科 主任 2006~迄今 加護病房 高雄醫學大學附設醫院 神經外科 主治醫師 1998~迄今 高雄醫學大學 外科學 助理教授 2006/01~迄今 經歷: 2003/08~2005/07 美國維吉尼亞大學 神經外科 研究員 1988/08~1994/07 高雄醫學大學附設醫院 外科 住院醫師 1994/08~1996/07 高雄醫學大學附設醫院 神經外科 總醫師 2000/08~2005/12 高雄醫學大學 外科學 講師 34
  • 35. 16:10~16:30 Name: Cheng-Loong Liang 梁 正 隆 Office Address: Department of Neurosurgery, E-DA Hospital, #1 E-DA Road, Yan-Chau Shiang, Kaohsiung County, 824, TAIWAN. Tel No: 886-7-6150011 Education: (2004 APR. ~ OCT.) Fellowship, Center for Imagine-Guided Neurosurgery, Department of Neurosurgery, University of Pittsburgh Medical Center, Pennsylvania, USA (1998~2002) Master of Medical Sciences, Institute of Clinical Medicine, Chang Gung University, Taiwan (1984~1991) Doctor of Medicine, Chung Shan Medical University, Taiwan Academic Appointment: Lecturer, I-Shou University Employment Record: (2004~ ) Director, Gamma Knife Center, E-DA Hospital, I-Shou University (2004~ ) Attending Neurosurgeon, Department of Neurosurgery, E-DA Hospital, I-Shou University (1999~2004) Attending Neurosurgeon, Department of Neurosurgery, Chang Gung Memorial Hospital, Kaohsiung Medical Center (1993~1999) Resident, Department of Surgery and Neurosurgery, Chang Gung Memorial Hospital, Kaohsiung Medical Center Board Certification: 1998, Board of Surgery (Taiwan) Board Certification: 1999, Board of Neurosurgery (Taiwan) Professional Affiliations: American Association of Neurological Surgeon (AANS) USA Surgical Association of R.O.C. (Taiwan) Medical Association of R.O.C. (Taiwan) Neurological Association of R.O.C. (Taiwan) Taiwan Neurosurgical Society Taiwan Stroke Society Honor and awards: 2001 Award of Professor Lee T.K., Taiwan Stroke Society 2003 Award of Professor Du S.B., Taiwan Stroke Society 35
  • 36. 16:30~16:50 駱子文 慈濟大學醫學系畢 花蓮慈濟醫學中心 神經外科 總醫師 花蓮慈濟醫學中心 神經外科 專科醫師(今年考取) 16:50~17:05 張軒凱 陽明大學醫學系畢業 台北榮總 神經外科 住院醫師 17:05~17:20 楊懷哲 台北醫學大學醫學系畢業 台北榮總 神經外科 總醫師 台北榮總 神經外科 專科醫師(今年考取) 17:20~17:35 李政家 陽明大學醫學系畢業 台北榮總 神經外科 住院醫師 36