遊離筋皮弁による前頭蓋底および顔面の2再建例

Reconstruction of Anterior Cranial Base and Face with Free Musclecutaneous Flap; Report of two cases

I．はじめに

　顔面の皮膚および骨を含む前頭蓋底欠損に対する再建においては，硬膜の再建による髄液漏の防止，露出骨の被覆，死腔の充填，および整容上の再建が問題となる．近年マイクロサージェリーの技術的進歩にともない，このような広範囲欠損を示す症例に対して，遊離皮弁による再建の有用性が唱えられている．

　今回われわれは，顔面皮下におよぶ前頭蓋底腫瘍の2切除例に対し，遊離広背筋皮弁および腹直筋皮弁を利用して再建を行い良好な結果を得たので若十の文献的考察を加えて報告する．

The treatment of extensive cranial base tumor is still challenging. Wide resection of a cranial base tumor would lead to exposure of the vital structures such as the brain and dura, and would result in a large dead space in the cranium and in the connecting area be-tween the nasal cavity and the intracranial space. Re-cently free tissue transfer has become a reliable method in the field of reconstructive surgery. In the cranio-facial region, free tissue transfer is useful to reconstruct a complicated defect.

We report two cases where free latissimus dorsi M-C flap and rectus abdominis M-C flap were useful in re-constructing the defect following removal of an anterior cranial base tumor. We discuss the advantages.