前額皮弁を応用した眉の再建

Eyebrow Reconstruction with a Forehead Flap

はじめに

　眉毛は顔面の重要な構成要素の1つであり，外傷や熱傷および腫瘍摘出などによって欠損を生じた場合には，整容面を考慮した再建が必要となる。

　眉の再建にあたっては，その形態，毛流，毛向，毛の質，毛の密度などの適合を考慮する必要がある。再建方法には有茎植毛術や遊離植毛術および単一植毛術があるが，眉の欠損範囲が大きい場合や骨が露出している場合には有茎植毛術を用いることになる。本稿では，有茎植毛術の一種である前額皮弁を用いた眉の再建について述べる。

　Eyebrows are an essential facial feature, and reconstructive procedures to restore cosmetic appearance are necessary for those with eyebrow loss secondary to trauma, burns, or tumor excision.

　Eyebrow reconstruction requires careful attention to symmetry between the left and right brows, their respective morphologies, the direction and quality of hair growth, and hair density. Several methods, such as local flaps, free graft transplantation, or single hair transplantation are available for eyebrow reconstruction. Local flaps are preferred in patients with large defects in eyebrow tissue or in those with exposed bone.

　The forehead flap, a classic surgical technique, is particularly useful for nasal reconstruction. However, it can also be used for eyebrow reconstruction; the flap is island shaped and includes the hairline hair. Hair from the hairline closely resembles eyebrow hair in texture, which enables natural-appearing reconstruction. Furthermore, the flap can include both hair and skin from the forehead area, and is therefore suitable for large tissue defects around the eyebrows. This flap may be a useful option in patients with extensive tissue defects around the eyebrows, including in those with exposed bone.