耳後部島状有茎皮弁による耳甲介部再建

A case of reconstruction of the concha of auricle using a postauricular island pedicle flap

I．はじめに

　耳甲介腔の軟骨を含む組織欠損を植皮のみで修復した場合，移植片の大半は色素沈着と中心性拘縮を生じ，再建耳甲介腔は浅く狭くなり，やがて消失し耳介全体が縮小する^1,2）。今回われわれは，右側耳甲介腔から対耳輪を越え耳輪に迫る母指頭大の扁平上皮癌切除後の組織欠損を，耳後部島状有茎皮弁^3,4,5）により再建する機会を得た。症例を報告し，若干の考察を加えた。

A 92-year-old man was treated surgically for a 25×20 mm squamous cell carcinoma on the right auricle spread from the area of concha to the helix. The operation was performed under local anesthesia,and the lesion was removed completely with a normal margin at the frozen section. Postauricular island flap containing the postauricular blood vessels and the greater auricular nerve was raised and introduced through a tunnel to the anterior aspect. The donor site was covered at the same time with a rotation rhombic flap. Both flaps survived completely,maintaining a good skin color and texture. The cosmetic result was gratified.