前額部皮膚腫瘍に対して皮下茎皮弁により良好な結果を得た2例

Favorable Results with an Advancement Flap for a Forehead Skin Tumor: A Case Report

はじめに

　前額部は，前頭・側頭の被髪部，眼窩上縁の眉毛，鼻根に囲まれた前頭部の無毛領域であり 1），類似した組織が得られにくく，整容的にも目立ちやすいため，再建方法に苦慮することが多い。

　現在，前額部の大きな皮膚腫瘍欠損に対する確立された再建方法はない。そこで今回われわれは皮下茎皮弁を用いた局所皮弁により整容的に良好な結果を得たため，その結果を報告する。

　The frontal region of the face presents challenges for reconstruction methods in cases of defects caused by tumors or trauma, with consideration of aesthetic units. Even when excision and simple closure are feasible, slight asymmetries or irregularities in height can result in noticeable deformities, raising cosmetic concerns.

　In the case of the 43-year-old and 12-year-old described herein, our use of an advancement flap based not only on wrinkle lines and relaxed skin tension lines (RSTLs) but also on unit theory for the skin defect after the excision of a forehead skin tumor allowed us to achieve a highly satisfactory and favorable outcome in terms of patient satisfaction.

　The incision on the proximal side of the flap was designed to follow the foreheadʼs wrinkle lines, while the distal-side incision was made along the upper margin of the eyebrows to ensure that the sutured incision aligned with the unit. The reconstruction was carried out using an external advancement flap.

　For forehead skin defects, considering units in addition to wrinkle lines and RSTLs when using an external advancement flap is recognized as an exceptionally effective reconstruction method for maintaining facial aesthetics.