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REGISTRATION FORM Name :______________________________________________________________________________ I/C No : _____________________________________________________________________________ Address : ____________________________________________________________________________ Tel : _____________________________ Fax : ______________________________________________ Email : ______________________________________________________________________________ I enclose a bank draft/cheque of 1 st International Lateral Skull based & 14t h Functional Endoscopic Sinus Surgery Workshop’ RM___________________________No _________________ for registration fee. Account Name: PERSATUAN ALLERGIC RHINITIS UKM Name of Bank: MAYBANK BERHAD Address of Bank: 102-6, Jalan Midah 1,Taman Midah,Cheras,56000, Kuala Lumpur Account Number: 564137510598 I would like to participate in the : (please √ at for selected workshop/participation) Organized by: Department of Otorhinolaryngology-Head and Neck Surgery Hospital Canselor Tuanku Muhriz, UKM Medical Center & UKM Allergic Rhinitis Association 23 rd - 24 th & 25 th - 26 th July 2018 Venue: Putrajaya Marriot Hotel , Malaysia 1 st International Lateral Skull Base & 14t h Functional Endoscopic Sinus Surgery Workshop

REGISTRATION FORM 1st International Lateral Skull Base ... · It is a great pleasure and honour to invite you to participate in the 14th Functional Endoscopic Sinus Surgery Workshop

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Page 1: REGISTRATION FORM 1st International Lateral Skull Base ... · It is a great pleasure and honour to invite you to participate in the 14th Functional Endoscopic Sinus Surgery Workshop

REGISTRATION FORM

Name :______________________________________________________________________________

I/C No : _____________________________________________________________________________

Address : ____________________________________________________________________________

Tel : _____________________________ Fax : ______________________________________________

Email : ______________________________________________________________________________

I enclose a bank draft/cheque of ‘1st International Lateral Skull based & 14th Functional Endoscopic

Sinus Surgery Workshop’ RM___________________________No _________________ for registration fee.

Account Name: PERSATUAN ALLERGIC RHINITIS UKM

Name of Bank: MAYBANK BERHAD

Address of Bank: 102-6, Jalan Midah 1,Taman Midah,Cheras,56000, Kuala Lumpur

Account Number: 564137510598

I would like to participate in the : (please √ at for selected workshop/participation)

Organized by:

Department of Otorhinolaryngology-Head and Neck Surgery Hospital Canselor Tuanku Muhriz, UKM Medical Center

&

UKM Allergic Rhinitis Association

23rd - 24th & 25th - 26th July 2018

Venue:

Putrajaya Marriot Hotel , Malaysia

1st International Lateral Skull Base &

14th Functional Endoscopic Sinus Surgery

Workshop

Page 2: REGISTRATION FORM 1st International Lateral Skull Base ... · It is a great pleasure and honour to invite you to participate in the 14th Functional Endoscopic Sinus Surgery Workshop

Course Director : Professor Dr. Asma Abdullah

Co-Course Director:

Associate Professor Dr. Salina Husain

Hon. Secretary : Dr. Farah Dayana Zahedi

Hon Treasurer

Dr. Noor Dina Hashim 1st International Lateral Skull

Base Workshop

Course Director : Professor Dr Asma Abdullah

Course Coordinator Dr Noor Dina Hashim

Committee Member

Muhammad Azhan Ubaidah

Suzana Mohamad Habit

Nurhidayah Abdul Kalil

14th Functional Endoscopic Sinus Surgery Workshop

Course Director : Associate Professor Dr Salina Husain

Course Coordinator

Dr Farah Dayana Zahedi

Committee Member

Muhammad Azhan Ubaidah

Normahani Mat Ail

Wan Norliana Azmi

ORGANISING COMMITEE

Contact us :

DEPARTMENT OF OTORHINOLARYNGOLOGY-HEAD AND NECK SURGERY Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia Medical Centre,

Tingkat 9, Blok Klinikal, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia

Tel: +603 –91456045 / 6047 / 5564 Fax: +603 – 9145 6675 E-mail : [email protected]

PARTNERS

Page 3: REGISTRATION FORM 1st International Lateral Skull Base ... · It is a great pleasure and honour to invite you to participate in the 14th Functional Endoscopic Sinus Surgery Workshop

It is my pleasure to welcome you to the 1st Interna-tional Lateral Skull Base Workshop 2018. This course is held to share knowledge and techniques on the re-cent updates on lateral skull base surgeries. This course offers a wide range of hands on regarding the pathologies of the ear, hearing issues, facial nerve to tumours of lateral skull base. We are honored to have Prof Dr Paul Van de Heyning from Antwerp, Belgium who is known of his extensive contributions in lateral skull base surgeries. Our pioneer neuro-otologist in

Malaysia, Prof. Dato’ Dr Lokman Saim who is also founder of UKM Cochlear implant program will be also involved. Managing lateral skull base tumours also requires the experts hands of the neurosurgeons. The mutual coopera-tion between the ORL and neuro-surgeons are made easy by the under-standings of both specialized fields.

The fresh cadaveric dissections offer great one to one experience on the anatomy of the lateral skull base. With tremendous support from sponsors, we would like to ensure a smooth and advanced dissection sessions.

I sincerely hope all of you will benefit from this 2-days workshop. Apart from gaining more skills and experience, it is also a platform to meet up members of same fraternity from all over the world.

Thank you and wish you an enjoyable course.

PROFESSOR DR ASMA ABDULLAH Course Director

1st International Lateral Skull Base Workshop 23rd-24th July 2018

MESSAGE FROM THE DIRECTOR

International Guest Faculty Prof Dr Paul Van de Heyning

Senior Consultant, Department of Otorhinolaryngology and Head and Neck Surgery Antwerp University Hospital

Dr. Soekirman Soekin Senior Consultant, Department of Otorhinolaryngology and Head and Neck Surgery

Jakarta , Indonesia

Local Faculty Prof Dr Asma Abdullah

Head of Department and Senior Consultant Department of Otorhinolaryngology-Head and Neck Surgery

Hospital Canselor Tuanku Muhriz, UKM Medical Center

Prof Dr Goh Bee See Senior Consultant, Department of Otorhinolaryngology-Head and Neck Surgery

Hospital Canselor Tuanku Muhriz, UKM Medical Center

Prof Dato Dr Lokman Saim President and Dean School of Medicine

KPJ Healthcare University College

Profesor Dr. Mohd Khairi Md Daud Head Department and Senior Consultant

Department of Otorhinolaryngology-Head and Neck Surgery Hospital university Sains Malaysia, Kubang Kerian, Kelantan

Mr Tengku Izam bin Tengku Kamaldeen Senior Consultant, Department of Otorhinolaryngology-Head and Neck Surgery

Hospital Sultan Ismail, Johor Bahru

Mr.Zulkiflee bin Salahuddin Senior Consultant, Department of Otorhinolaryngology-Head and Neck Surgery

Hospital Raja Perempuan Zainab II, Kelantan

Ascc. Prof Dato Dr Rahman Izaini Senior Consultant, Department of Neurosciences

Hospital Universiti Sains Malaysia, Kota Bharu

Ascc. Prof Dr Azizi Abu Bakar Senior Consultant, Unit Neurosurgery, Department of Surgery

Hospital Canselor Tuanku Muhriz, UKM Medical Center

Mr Azmi Alias Senior Consultant , Department of Neurosurgery

Hospital Kuala Lumpur

FACULTY

Page 4: REGISTRATION FORM 1st International Lateral Skull Base ... · It is a great pleasure and honour to invite you to participate in the 14th Functional Endoscopic Sinus Surgery Workshop

DAY 1 (23rd July 2018)

_______________________________________________________________________________________________________________________________________________________________________________________ 8.00-8.15 am : Registration

8.15-8.30 am : Opening ceremony and welcoming speech 8.45-9.15 am : Radiology of ear and lateral skull base ( Prof Dr Asma Abdullah) 9.15-9.45am : Video of BAHA Implant and Bone Bridge Surgery (Prof Dr Goh Bee See & Mr Tengku Izam) 9.45-10.15am : Video of mastoid surgery , Posterior tympanotomy, Cochlear Implant (Prof Dato Dr Lokman Saim) 10.15-10.45 am : TEA BREAK & PHOTO SESSION 10.45-1.00 pm : Cadaveric dissection 1 : BAHA surgery, Bone Bridge, cortical mastoidectomy, Posterior tympanotomy (Prof Dato Dr Lokman Saim & Mr Tengku Izam ) 1.00-2.00 pm : LUNCH 2.00-3.00pm : Cadaveric dissection 2 : Cochlear Implant, Facial nerve decompression, Modified radical mastoidectomy (Prof Dr Paul Van de Heyning & Prof Dr Asma Abdullah) 3.00-3.30 pm : Lateral approach to internal auditory canal (Prof Dr Paul Van de Heyning) 3.30-4.45 pm : Cadaveric dissection 3: Identification of labyrinth, endo- lymphatic decompression, labyrinthectomy, approach to internal auditory canal (Prof Dr Paul Van de Heyning & Prof Dato’ Dr Lokman Saim) 4.45-5.00 pm : TEA BREAK _________________________________________________________________________________

Observers

Day 1 Topics

10.45-11.30 am : Cochlear Implant in Tinnitus Patient (Prof Paul Van De Heyning)

11.30– 12.00 pm : Management of Mastoid Abscess (Ms Noor Dina Hashim)

12.00-12.30 pm : How do I Manage Giant Cholestetoma? (Dr Soekirman Soekin)

02.15 - 03.00 pm : Translabryntine Approach for Acoustic Neuroma Surgery (Prof. Dato’ Dr. Lokman Saim)

PROGRAMME

DAY 2 (24thJuly 2018)

_______________________________________________________________________________________________________________________________________________________________________________________ 8.30-9.00 am : Surgical anatomy of lateral skull base (Ascc. Prof Dato Dr Abdul Rahman Izaini) 9.00-9.30am : Retrosigmoid and middle fossa approach to internal auditory canal ( Ascc. Prof Dr Azizi Abu Bakar) 9.30-10.00am : TEA BREAK

10.00-1.00pm : Cadaveric dissection 4 : Retrosigmoid dissection (Ascc. Prof Dato Dr Rahman Iziani & Mr Azmi Alias & Ascc. Prof Dr Azizi Abu Bakar) 1.00- 2.00 pm : LUNCH 2.00-3.00 pm : Combine middle and posterior fossa approach (Ascc. Prof Dr Azizi Abu Bakar) 3.00-3.30 pm : Cadeveric dissection 5 : Middle fossa approach to internal auditory canal (Ascc.Prof Dr Azizi Abu Bakar & Mr Azmi Alias ) 3.30 - 4.45pm : Cadaveric dissection 6 : Middle ear exploration and carotid artery identification and dissection (Prof Dr Paul Van de Heyning & Mr Tengku Izam) 4.45-5.00 pm : CLOSING REMARK & TEA BREAK _________________________________________________________________________________

Observers

Day 2 Topics

10.00 -10.45 am : Otogenic Brain Abscess (Mr Azmi Alias)

10.45-11.30 am : Update on Meningioma Management and Acoustic Neuroma (Prof Yeop @ Rahman Izani)

11.30–12.15 pm : Current management of Glomus Tumor (Prof Dr Mohd Khairi Md Daud)

02.15 - 03.00 pm : Endoscopic Laterall skull Base: HSI Experience. (Mr Tengku Izham Tengku Kamaldeen)

PROGRAMME

Page 5: REGISTRATION FORM 1st International Lateral Skull Base ... · It is a great pleasure and honour to invite you to participate in the 14th Functional Endoscopic Sinus Surgery Workshop

It is a great pleasure and honour to invite you to participate in the 14th Functional Endoscopic Sinus Surgery Workshop at the Putrajaya Marriott Hotel, Putrajaya, Malaysia, from 25th to 26th July 2018.

This comprehensive course design to provide knowledge about the anatomy of the nose, endoscopic sinus surgery and a chance for the participants to have an experience in operating sinus disease case by the hands on cadaveric dissection

session. The cadaveric dissection session will be demonstrated by a renowned Rhinology Senior Consultant Associate Professor Dr Kornkiat Snidvongs from Bangkok, Thai land. Each of the station will be supervised by our distinct teaching faculty members.

We hope that you will join us and have an exciting opportunity to gain further knowledge in Endoscopic Sinus Surgery while enjoying the social interaction and networking among the local and international participants. We believe it will be a most worthwhile workshop and a truly memorable experience.

Please note that the space for dissectors is limited and will be allocated on first come, first served basis. Therefore, grab your chance to secure your participation by registering your name early.

Thank you and do enjoy the workshop.

ASSOCIATE PROFESSOR DR SALINA HUSAIN Course Director 14th Functional Endoscopic Sinus Surgery Workshop

14th Functional Endoscopic Sinus Surgery Workshop 25th-26th July 2018

MESSAGE FROM THE DIRECTOR

International Guest Faculty

Associate Professor Dr Kornkiat Snidvongs

Senior Consultant Deparment of Otolaryngology

Chulalongkorn University Bangkok, Thailand

Dr Vicky Riyadi

Senior Consultant Department of Otorhinolaryngology

RSUP Fatmawati Jakarta, Indonesia

Local Faculty

Professor Dr Baharudin Abdullah Senior Consultant

Department of Otorhinolaryngology Hospital Universiti Sains Malaysia

Dato’ Dr Balwant Singh Gendeh

Senior Consultant Otorhinolaryngology Pantai Medical Center, Kuala Lumpur

Associate Professor Dr Salina Husain

Senior Consultant Department of Otorhinolaryngology-Head and Neck Surgery

Hospital Canselor Tuanku Muhriz, UKM Medical Center

Dr Farah Dayana Zahedi Specialist

Department of Otorhinolaryngology-Head and Neck Surgery Hospital Canselor Tuanku Muhriz, UKM Medical Center

FACULTY

Page 6: REGISTRATION FORM 1st International Lateral Skull Base ... · It is a great pleasure and honour to invite you to participate in the 14th Functional Endoscopic Sinus Surgery Workshop

DAY 1 (25th July 2018) __________________________________________________________________

8.00 - 8.30 am : Registration

8.30 - 8.40 am : Welcoming Speech

8.40 - 10.20 am : Anatomy of the Nose and Paranasal Sinuses (Associate

Professor Dr Kornkiat Snidvongs)

10.20 - 10.50 am: TEA BREAK AND PHOTO SESSION

10.50 - 11.45 am: How to Read Computed Tomography Scan of

Paranasal Sinuses (Associate Professor Dr Salina Husain)

11.45 - 12.30 pm: Cadaveric Dissection 1

(Uncinectomy, Middle Meatal Antrostomy, Anterior and

Posterior Ethmoidectomy, Sphenoidotomy)

12.30 - 1.00 pm : Lunch Symposium (TBC)

1.00 - 2.00 pm : LUNCH

2.00 - 3.30 pm : Cadaveric Dissection (Cont’d)

(Identification of Anterior and Posterior Ethmoidal

Arteries)

3.30 - 4.30 pm : Cadaveric Dissection 2

(Orbital and Optic Nerve Decompression)

4.30 - 5.00 pm : TEA BREAK

PROGRAMME

DAY 2 (26th July 2018) __________________________________________________________________

8.00 - 10.00 am : Cadaveric Dissection 3

(Endoscopic Dacrocystorhinostomy)

10.00 - 10.30 am: TEA BREAK

10.30 - 11.15 am : Hemostasis in Endoscopic Sinus Surgery (Professor Dr

Baharudin Abdullah)

11.15 - 12.30 pm: Cadaveric Dissection 4

(Endoscopic Partial Medial Maxillectomy)

12.30 - 1.00 pm : Lunch Symposium (TBC)

1.00 - 2.00 pm : LUNCH

2.00 - 3.30 pm : Cadaveric Dissection 5

(Sphenopalatine and Internal Maxillary Artery Ligation)

3.30 - 4.30 pm : Cadaveric Dissection 6

(Frontal Sinus Surgery Type 1, 2, & Modified Lothrop

Procedure)

4.30 - 5.00 pm : CLOSING REMARK & TEA BREAK

***Transcribriform, transplanum & transellar approches will be

demonstrated if time permitted

PROGRAMME