走路常撞到門框、看不到旁邊
Bumping into door frames
兩側視野慢慢變窄，自己不一定察覺，常是開車或家人提醒才發現。
Side vision narrows slowly and often goes unnoticed until driving or family point it out.
可能相關：腫瘤壓迫視神經交叉
Possibly: tumour pressing on the optic chiasm
Pituitary · Skull Base · Spine
腦下垂體只有豌豆大，
卻牽動全身的荷爾蒙。
The pituitary is the size of a pea, yet it runs the body's hormones.
我是李瑤琳，奇美醫院神經外科主治醫師。我專注於腦下垂體腫瘤與顱底疾病，以經鼻內視鏡從鼻腔到達病灶，不需在頭上開刀。我也受過完整的神經外科訓練，經常執行脊椎的減壓、固定與融合手術，從腦部到脊椎，都能為你做整體的評估。
I'm Dr. Yao Lin Lee, attending neurosurgeon at Chi Mei Medical Center. I focus on pituitary tumours and skull base disease, reaching them through the nose with an endoscope instead of opening the skull. With full neurosurgical training, I also regularly perform spinal decompression, fixation and fusion, so I can look at the whole picture from brain to spine.
李瑤琳 醫師Dr. Yao Lin Lee, MD
神經外科專科醫師・台灣腦下垂體學會理事Board-certified neurosurgeon · Governing Board, Taiwan Pituitary Society
先看這裡
Start here
腦下垂體的問題，常常不像「腦」的問題
Pituitary problems rarely feel like brain problems
很多病人在眼科、婦產科、新陳代謝科繞了一圈，才發現原因在腦下垂體。如果下面的描述讓你覺得熟悉，值得找醫師評估。
Many patients see an eye doctor, a gynaecologist or an endocrinologist before anyone looks at the pituitary. If any of these sound familiar, it's worth an assessment.
月經不規則、沒懷孕卻有泌乳
Irregular periods or milk discharge
男性則可能是性慾下降。抽血常會看到泌乳激素偏高。
In men, this can show up as low libido. Bloodwork often shows high prolactin.
可能相關：泌乳激素瘤（多數先用藥物）
Possibly: prolactinoma (usually treated with medication first)
戒指戴不下、鞋子越買越大
Rings and shoes no longer fit
臉型、下巴、手腳慢慢變大，常伴隨打鼾、關節痛、出汗多。
Gradual changes in the face, jaw, hands and feet, often with snoring, joint pain and sweating.
可能相關：生長激素腺瘤（肢端肥大症）
Possibly: growth hormone adenoma (acromegaly)
血壓血糖怎麼控制都不穩
Blood pressure and sugar won't settle
加上臉變圓、肚子變大、皮膚容易瘀青或出現紫紋。
Together with a rounder face, central weight gain, easy bruising or purple stretch marks.
可能相關：庫欣氏病
Possibly: Cushing's disease
一直很累、怕冷、提不起勁
Constant fatigue and feeling cold
容易被當成工作太累。其實可能是多種荷爾蒙同時不足。
Easy to blame on overwork. It may be several hormones running low at once.
可能相關：腦下垂體功能低下
Possibly: hypopituitarism
健檢 MRI 意外發現一個「小東西」
An MRI found something by chance
大部分不需要開刀，但需要確認荷爾蒙與視野，並安排追蹤間隔。
Most don't need surgery, but hormones and vision should be checked and follow-up planned.
可能相關：偶發腦下垂體瘤
Possibly: pituitary incidentaloma
這些症狀也可能有其他原因，這裡的整理不能取代門診評估。閱讀完整的腦下垂體說明 →
These symptoms have other causes too. This list does not replace a clinical assessment.
經鼻內視鏡手術
Endoscopic endonasal surgery
從鼻孔進去，不在頭上開刀
Through the nose, not through the skull
腦下垂體在頭顱的正中央，從頭頂或側邊開刀要繞過大腦；從鼻腔走，反而是最短、最直接的路。內視鏡讓我在手術中看到廣角、高解析度的影像。
The pituitary sits at the very centre of the head. Going through the nose is the shortest, most direct path, and the endoscope gives a wide, high-definition view during surgery.
- Incision
- 臉上與頭皮沒有傷口
- No incision on the face or scalp
- Nose
- 外觀不改變；術後數週內可能鼻塞、需鼻腔沖洗
- Appearance unchanged; congestion and saline rinses for a few weeks
- Stay
- 住院天數依病況而定，大多數為 3–5 天
- Length of stay varies; most patients stay 3–5 days
- Team
- 與內分泌科、眼科、耳鼻喉科共同照顧
- Shared care with endocrinology, ophthalmology and ENT
門診評估
First consultation
看你的症狀與影像，畫圖說明腫瘤在哪裡、壓到什麼。
We review your symptoms and scans, and I sketch where the tumour is and what it touches.
荷爾蒙抽血、MRI、視野檢查
Hormones, MRI, visual fields
這三項決定腫瘤的類型，以及需不需要處理、多急。
These three tell us the tumour type, whether it needs treatment, and how soon.
決定治療方式
Choosing a plan
追蹤、藥物、手術或放射治療，我們一起討論利弊。
Observation, medication, surgery or radiation. We weigh the options together.
手術與住院
Surgery and hospital stay
術後密切監測尿量與荷爾蒙，留意尿崩症等變化。
Afterwards we watch urine output and hormones closely, including for diabetes insipidus.
長期追蹤
Long-term follow-up
定期回診抽血與 MRI。腦下垂體的照顧是一段長時間的合作。
Regular bloodwork and MRI. Pituitary care is a long partnership.
不是每一顆腦下垂體瘤都需要開刀。泌乳激素瘤多數可以先用藥物控制；很小、沒有症狀的腫瘤，通常定期追蹤即可。我會先告訴你不開刀的選項。
Not every pituitary tumour needs surgery. Most prolactinomas respond to medication, and small tumours without symptoms can usually be watched. I'll walk you through the non-surgical options first.
脊椎手術
Spine surgery
脖子到腰，神經被壓到的時候
When nerves are pinched, from neck to lower back
脊椎手術是神經外科日常的一大部分。從頸椎前位手術、後位減壓固定，到腰椎融合，我依照壓迫的位置與脊椎穩定度選擇術式，能用小傷口完成的，就不開大傷口。
Spine surgery is a large part of everyday neurosurgery. From anterior cervical surgery to posterior decompression and lumbar fusion, I choose the approach by where the compression is and how stable the spine is, using smaller incisions wherever they do the job.
Cervical
手麻、扣釦子變得不靈活
Numb hands, clumsy with buttons
寫字、拿筷子變差，走路不穩。這可能是頸椎壓迫到脊髓，不要拖。
Handwriting and chopsticks get harder, walking feels unsteady. This can mean the cervical cord is compressed; don't wait.
Cervical
脖子痛，一路麻到手指
Neck pain running into the fingers
單側手臂痠麻無力，抬頭或轉頭時更明顯。
One arm aches, tingles or weakens, worse when looking up or turning.
Lumbar
走一段路就要停下來休息
Having to stop after a short walk
腿痠麻到走不動，坐下或彎腰就舒緩，是腰椎管狹窄的典型表現。
Legs ache until you stop; sitting or bending forward helps. A classic sign of lumbar stenosis.
Lumbar
腰痛加上坐骨神經痛
Back pain with sciatica
從屁股痛到小腿或腳背，可能是椎間盤突出或腰椎滑脫。
Pain from the buttock down to the calf or foot, often a disc herniation or spondylolisthesis.
術式Procedure白話說明In plain words常見適應症Usually for
前位頸椎椎間盤切除與融合
Anterior cervical discectomy & fusion
ACDF從脖子前方約 3–4 公分的橫向小切口進入，移除壓迫神經的椎間盤與骨刺，再放入支架讓兩節頸椎癒合。傷口通常沿著頸部皺褶，癒合後不明顯。
A small horizontal incision at the front of the neck. The disc and bone spurs pressing on nerves are removed, then a spacer lets the two vertebrae fuse. The scar usually follows a natural skin crease.
適合FOR頸椎椎間盤突出、骨刺造成的神經根或脊髓壓迫Cervical disc herniation or spurs compressing nerve roots or the cord
後位減壓與固定
Posterior decompression & fixation
Laminectomy / laminoplasty · pedicle screws從背後把壓迫神經的椎板、韌帶拿掉，讓神經有空間；若脊椎不穩定，再用螺釘與連桿固定。頸椎與腰椎都適用。
From the back, the bone and ligament crowding the nerves are removed to give them room. If the spine is unstable, screws and rods hold it in place. Used in both the neck and lower back.
適合FOR多節段椎管狹窄、後縱韌帶鈣化、外傷或腫瘤造成的不穩定Multilevel stenosis, OPLL, instability from trauma or tumour
經椎間孔腰椎椎間融合
Transforaminal lumbar interbody fusion
TLIF · MIS-TLIF從背後側邊進入，清除椎間盤、解除神經壓迫，放入椎間支架並以螺釘固定，讓滑脫或不穩的腰椎重新穩定。適合時可用微創方式、經皮置入螺釘，減少肌肉破壞。
Through the back, slightly to one side: the disc is cleared, the nerves are freed, and a cage plus screws stabilise the segment. When suitable, it's done minimally invasively with percutaneous screws to spare the muscles.
適合FOR腰椎滑脫、椎間盤退化合併不穩定、復發性椎間盤突出Spondylolisthesis, degenerative instability, recurrent disc herniation
微創腰椎減壓
Minimally invasive lumbar decompression
MIS decompression · microdiscectomy用管狀牽開器與顯微鏡，經小傷口移除突出的椎間盤或增生的骨頭，不需要固定。多數病人術後隔天即可下床。
Through a small tubular retractor under the microscope, the herniated disc or overgrown bone is removed without fusion. Most patients are up the next day.
適合FOR單純椎間盤突出、未合併不穩定的椎管狹窄Simple disc herniation, stenosis without instability
多數腰痠背痛不需要開刀。藥物、復健、運動調整與神經阻斷注射，常常就能改善。我會在手術前確認保守治療已經試過，或者出現了不該再等的警訊，例如無力、大小便控制變差。
Most back and neck pain doesn't need surgery. Medication, physiotherapy, activity changes and nerve blocks often help. I recommend surgery once conservative care has been tried, or when warning signs appear that shouldn't wait, such as weakness or bladder and bowel changes.
治療範圍
Scope of practice
專注腦下垂體，背後是完整的神經外科訓練
Focused on the pituitary, backed by full neurosurgical training
次專科讓我在腦下垂體與顱底看得更深；完整的神經外科訓練，讓我在面對脊椎神經壓迫、腦瘤或外傷時，能從整個神經系統來判斷。
Subspecialty focus gives depth in pituitary and skull base surgery. General neurosurgical training lets me judge headaches, nerve compression and trauma across the whole nervous system.
主要專長
Primary focus
腦下垂體與鞍區腫瘤
Pituitary & sellar tumours
- 無功能性腦下垂體腺瘤
- 泌乳激素瘤、生長激素瘤、庫欣氏病
- 拉克氏囊腫、腦下垂體中風
- Non-functioning adenomas
- Prolactinoma, acromegaly, Cushing's disease
- Rathke's cleft cyst, pituitary apoplexy
經鼻內視鏡手術・與內分泌科共同照護
Endoscopic endonasal surgery · co-managed with endocrinology
顱底
Skull base
內視鏡顱底手術
Endoscopic skull base surgery
- 顱咽管瘤、鞍結節腦膜瘤
- 脊索瘤等斜坡腫瘤
- 腦脊髓液鼻漏修補
- Craniopharyngioma, tuberculum meningioma
- Chordoma and clival tumours
- CSF leak repair
擴大經鼻內視鏡・顱底重建
Extended endonasal approach · skull base reconstruction
脊椎
Spine
頸椎與腰椎手術
Cervical & lumbar spine surgery
- 前位頸椎椎間盤切除與融合（ACDF）
- 頸、腰椎後位減壓與螺釘固定
- TLIF／微創 TLIF、微創減壓
- Anterior cervical discectomy & fusion (ACDF)
- Posterior cervical/lumbar decompression & fixation
- TLIF / MIS-TLIF, minimally invasive decompression
一般神經外科
General neurosurgery
腦腫瘤與神經外傷
Brain tumours & neurotrauma
- 腦瘤評估與手術
- 頭部外傷、硬腦膜下出血
- 慢性硬腦膜下血腫
- Brain tumour assessment and surgery
- Head injury, subdural haemorrhage
- Chronic subdural haematoma
奇美醫院神經外科團隊
Chi Mei neurosurgery team
關於我
About me
嗨，我是李瑤琳醫師
Hello, I'm Dr. Lee
腦下垂體的病人，常常帶著一疊檢查報告和一連串沒有答案的問題來到門診。我希望每一次看診結束時，你能清楚知道三件事：腫瘤在哪裡、它對你有什麼影響、接下來有哪些選擇。
我在奇美醫院擔任神經外科主治醫師，次專科專注於腦下垂體、顱底與內視鏡手術。我也持續在約翰霍普金斯大學進修應用生醫工程，因為我相信更好的工具，能讓手術更安全。
Pituitary patients often arrive with a stack of reports and many unanswered questions. By the end of each visit, I want you to know three things: where the tumour is, how it affects you, and what your options are.
I'm an attending neurosurgeon at Chi Mei Medical Center with a subspecialty focus in pituitary, skull base and endoscopic surgery. I'm also completing an MSc in Applied Biomedical Engineering at Johns Hopkins, because better tools make surgery safer.
— 李瑤琳
— Yao Lin Lee
Board
台灣腦下垂體學會 理事
Governing Board, Taiwan Pituitary Society
MSc
美國約翰霍普金斯大學 應用生醫工程碩士（進修中）
MSc Applied Biomedical Engineering, Johns Hopkins University (in progress)
2023
國家級創新競賽獲獎兩項（吞嚥壓力訓練裝置、創傷訓練模型）
Two national innovation awards (swallowing training device, trauma training model)
2021 –
奇美醫學中心 神經外科 主治醫師
Attending Neurosurgeon, Chi Mei Medical Center
Cert.
中華民國神經外科專科醫師（奇美醫院住院醫師訓練）
Board-certified neurosurgeon, Taiwan (residency training at Chi Mei Medical Center)
2014
國防醫學院 醫學系
MD, National Defense Medical Center
看診前
Before your visit
第一次看診，帶這些來
Bring these to your first visit
準備齊全，第一次門診就能做出比較完整的判斷，省下你來回跑的時間。可以直接在這裡勾選。
With these in hand, we can make a fuller assessment at the first visit and save you extra trips. Tick them off here.
衛教文章
Articles
門診最常被問的問題
Questions I hear most in clinic
每一篇都從病人真正問過的問題出發。
Each one starts from a question a patient actually asked.
偶發瘤
Incidentaloma
健檢 MRI 說腦下垂體有個小東西，我需要開刀嗎？
My MRI found a small pituitary lesion. Do I need surgery?
大小、荷爾蒙、視野，三個數字決定下一步。
Size, hormones and vision decide the next step.
閱讀解答 →
Read the answer →
泌乳激素
Prolactin
泌乳激素偏高，一定是腫瘤嗎？
High prolactin: is it always a tumour?
藥物、壓力、甲狀腺都可能讓數字升高。
Medication, stress and the thyroid can all raise it.
閱讀解答 →
Read the answer →
手術
Surgery
經鼻內視鏡手術後，鼻子會變形嗎？嗅覺會不見嗎？
Will endoscopic surgery change my nose or sense of smell?
術後恢復期間會發生什麼，一次說清楚。
What recovery actually looks like, step by step.
閱讀解答 →
Read the answer →
門診資訊
Clinic
門診時間與掛號
Clinic hours & booking
門診時間如有異動，以醫院官網公告為準。
If hours change, the hospital's official schedule takes precedence.
| 一Mon | 二Tue | 三Wed | 四Thu | 五Fri | 六Sat | |
|---|---|---|---|---|---|---|
| 上午AM | ● | |||||
| 下午PM | ● | |||||
| 夜間Eve | ●* |
* 週三夜診為單數週開診。出發前建議再到掛號系統確認當週是否有診。* Wednesday evening clinic runs on odd-numbered weeks only. Please check the booking system for that week before coming.
院區Site奇美醫學中心 永康院區Chi Mei Medical Center, Yongkang campus
地址Address台南市永康區中華路901號
若出現突然劇烈頭痛、視力急速變差、意識改變，可能是腦下垂體中風，請立即前往急診或撥打 119，不要等候門診。
Sudden severe headache, rapid vision loss or confusion may signal pituitary apoplexy. Go to the emergency department or call 119; don't wait for a clinic appointment.