鼻中隔を用いた眼瞼形成術

Reconstruction of the eyelid using a nasal septal mucosa as graft material

　下眼瞼悪性黒色腫および上眼瞼基底細胞腫の2症例に対し，鼻中隔軟骨および粘膜より成るcomposite graftを用いた眼瞼形成術を行い，良好な結果が得られた．

　鼻中隔片の長所は（1）高い支持性．（2）自己移植で安定．（3）瞼板，結膜の同時補充．（4）採取が美容上問題ない．短所は（1）身体他部に傷をつくる．（2）採取が比較的面倒．（3）瞼板より厚く硬い．眼球前面への密着性に留意．（4）採取不能例がある．

　鼻中隔は，今日においても，特に大欠損例や1回の手術で再建を完了する場合に，極めて有用な眼瞼再建材料である．

We treated two cases with malignant tumor in the eyelid. To reconstruct defects in the eyelid, we used a composite free graft of nasal septal mucosa as substitute for the conjunctiva and the tarsal plate.

In the first case, satisfactory functional and cos-metic results were obtained even through the surgi-cally induced defect was twice as wide as the lower eyelid. In the second case, the surgical defect in-volved three-fourths of the upper eyelid and one-fourth of the lower eyelid. These defects could be filled and rebuilt in one surgical session with the present technique.

Composite graft of the nasal septal mucosa is recommended for its high supporting ability and safety as autograft. Use of this material allow re-building combined defects in the tarsal plate and the conjunctiva in one single session. It is particu-larly effective in cases with large or complicated defects of the eyelid.