前額部生え際の中間毛を含めた島状皮弁による眉の再建

Eyebrow Reconstruction with Intermediate Hair from the Forehead Hairline Using a Pedicled Temporoparietal Fascial Flap

　本論文は「Motomura H, et al: Eyebrow reconstruction with intermediate hair from the hairline of the forehead on the pedicled temporoparietal fascial flap. Ann Plast Surg 51: 314-318, 2003」の二次出版である（本誌掲載にあたって，一部加筆修正した）。

はじめに

　眉毛は顔の印象を決定する存在であり，その欠損は外観上奇異な印象を与えるとともに，本人の心理的影響も大きく，社会生活を送るうえで劣等感の原因となる。眉毛部は皮膚悪性腫瘍の好発部位でもあり，腫瘍切除後の眉毛欠損が大きく再建に難渋することが多い。これまで種々の眉毛再建法についての報告が見られるが，大きな欠損部の再建においては満足できるものは少ない。今回われわれは，側頭頭頂筋膜皮弁（temporoparietal fascia flap：以下，TPF flap）を茎とした前額部の生え際の中間毛を含む皮弁を，腫瘍切除後の比較的大きな眉の再建に用いた。TPF flapを用いた眉の再建についての報告は散見されるが，生え際の中間毛を利用した報告はわれわれの渉猟し得た範囲内では見られない。本法は，比較的大きな眉の欠損に対する再建において有効な方法であると考えられたので，報告する。

　There are reports of various procedures for eyebrow reconstruction, but few have produced satisfactory results for reconstruction of eyebrow loss extending to a large area. We describe here our experience with eyebrow reconstruction for a relatively large area following tumor resection, using intermediate hair from the hairline of the forehead on a pedicled temporoparietal fascial (TPF) flap.

　A 24-year-old man presented with an adnexal carcinoma of the left eyebrow. An intermediate hair flap was prepared at the hairline of the forehead in accordance with the defect. Meanwhile, a 48-year-old female patient was diagnosed with Bowenʼs disease of the left eyebrow. Tumor resection was performed on the frontal muscle with a 5-mm surgical margin from the tumor. An intermediate hair flap was prepared at the hairline of the forehead in accordance with the defect. The reconstructed eyebrows have maintained their shapes well.

　There have been several reports describing the use of the TPF flap for eyebrow reconstruction, but none have employed intermediate hair from the hairline. We are convinced that use of the TPF flap as described is effective for reconstruction of eyebrow loss extending to a comparatively large area.