鼻唇溝皮弁と頰粘膜弁を用いる上口唇即時再建術―上口唇右半側全層欠損の1症例

Immediate repair of the upper lip defect by nasolabial flap and buccal mucosal flap: a case of full thickness tissue loss on the right half of the upper lip

はじめに

　口唇の全層欠損創を対側口唇皮弁や口唇周囲の局所皮弁で再建する際，一般的には表面が皮膚，裏面が粘膜の状態で皮弁が作製され使用される。今回，上口唇に発生した粘表皮癌症例で，右側人中稜から右口角に至る広範囲全層欠損創の再建に対して，皮膚面は鼻唇溝皮弁の皮下茎島状弁で，粘膜面は上歯肉頰粘膜境部を基部とした頰粘膜弁で表裏摺り合わせるように使用し良好な結果が得られたので術式を中心に詳述した。

　The patient was an 89-year-old woman with mucoepidermoid carcinoma of the right portion of the upper lip. After wide resection of the tumor, full thickness tissue loss of almost right half of the upper lip was remained. The resultant was repaired immediately by transposing a subcutaneous pedicled nasolabial island flap to the surface of the lip, and the lining of the flap was covered by rotation of a random pattern buccal mucosal flap. Using both buccal mucosal flap with nasolabial flap simultaneously for reconstruction of a large defect of the upper lip obtained good fuctional and cosmetic result.