硬口蓋粘膜移植による下眼瞼再建

Reconstruction of the lower eyelid with mucosal grafting from the hard palate

　7例の下眼瞼全層欠損後の後葉再建に硬口蓋粘膜を用い，良好な結果を得た。硬口蓋粘膜は2.5cm程度のものまでは容易に採取可能であり，止血を十分に行えば特に保護床を装着しなくても術後4週までに上皮化し，ドナーの変形は最小限であった。硬口蓋粘膜は強い支持力を持った粘膜組織であるため，それのみで代用瞼板としての役割を持つ。また厚みや大きさの細工も容易に行え，彎曲の程度も良好で，角膜や眼球結膜への密着性がよい。支持力については健常瞼板や軟骨組織にはやや劣るが，健常瞼板を犠牲にしない点や軟骨組織より細工が容易であることを考慮すると，硬口蓋粘膜は極めて有用な再建材料であるといえる。

We tried to reconstruct the large full-thickness defect of the lower eyelid due to lid tumor in 7 cases. We used mucosal graft from the hard palate to substitute the conjunctiva and the tarsal plate. It was easy to obtain the mucosal graft. In all the cases, the treated area reepithelialized from the surrounding mucosa within 4 weeks after surgery. The reconstructed eyelids were satisfactory in function and appearance. The mucosa from the hard palate had features similar to the tarsal plate in consistence, thickness and elasticity resulting in good apposition to the eyeglobe. It was also easy to be cut to desired shape and thickness during surgery.