脂腺癌の上眼瞼再建後睫毛乱生および毳毛乱生に埋没U字縫合を施行した1例

Use of double-armed buried suture to treat trichiasis after upper eyelid reconstruction in a case of sebaceous carcinoma

要約　目的：睫毛乱生の治療法としてlid-splitting法，Hotz法，埋没U字縫合などがある。埋没U字縫合法は有効な治療法と考えられているが，眼瞼再建術後の報告はない。今回脂腺癌に対する上眼瞼全層切除後の睫毛乱生（含む毳毛乱生）に対して，埋没U字縫合を行い軽快した症例を報告する。症例：患者は67歳女性，脂腺癌と診断した。25か月前に腫瘍切除術および再建術，13か月前に硬口蓋粘膜を移植したが，睫毛乱生が再発し埋没U字縫合手術を行った。術後1年後の現在まで経過良好であり，再発はない。ただし本手術には，外反・瞼縁部の発赤・縫合糸の露出などの合併症が考えられた。結論：埋没U字縫合で良好な成績が得られた。

Abstract.　Purpose：To report a case of sebaceous carcinoma of the upper eyelid who received resection followed by double-armed buried suture to treat trichiasis. Case：A 67-year-old female presented with deformation in her left upper eyelid. She had been diagnosed with chalazion 5 years before and been treated by incision. Findings：Biopsy of the eyelid showed sebaceous carcinoma. The tumor was resected and the defect was reconstructed. She received transplantation of mucous membrane from the hard palate 12 months later. Another 13 months later,trichiasis was treated by double-armed buried suture. She had been doing well for 12 months until present. There has been no recurrence of the tumor. Conclusion：Use of double-armed buried suture was effective to treat trichiasis that developed after upper eyelid reconstruction in a case of sebaceous carcinoma.