上顎切除術に於ける小田式皮膚切開に就て

　上顎切除術に用いられる皮膚切開はデイエツフエンバツハ以來色々の提唱があり，殊にウエーベル及びウエルポウの皮切は最も慣用され，其の代表的なものではあるが，之等は顏面に加える皮膚切開が過大又は複雜なるため其の結果美容上著しき醜形を残し，或は顔面神経，三叉神経，ステノン氏管等を損傷して顏筋麻痺眼瞼閉鎖不全，眼瞼外飜，兎眼，流涙を來し或は切開創縁部の壞死を來し易い等，必ずしも満足すべきものでない事は経驗を有するものの等しく認める所であろう．近年ポルトマン，星野，ローランス等の如き比較的簡單なる皮切が　みられる傾向にあるのもむべなりと言うべきである．勿論此の際，相手は癌である．故に徒らに皮膚切開が顏貌に及ぼす影響を顧慮するの余り，腫瘍そのものゝ剔出を制約するが如き術式を撰ぶ事は誤りである．

　然し乍ら果してウエーベル，ウエルポウ等の如き切開を必要とするやは疑問がある．

Miyamoto says, in laying down the plans for making skin incision in case of reomval of maxil-lary bone, Oda's method which consists of sim-ple line of incision that extend from the edge of the upper lip to the anterior nare is far more advantageous than other methods for avoiding functional disturbances which were quite freque-ntly met with following various incisions emplo-yed in the past. It allows full exposure of the field of operation. Nasal mucous membranes may be easily separated from adjacent soft tis-sups; further separation may be carried up to-wards the nasal bone by starting it at the edge of the pyriform aperture and it may be extended laterally over the canine fossa until the entire surface of the maxilla is uncovered. Results of operation with use of this method for removal of malignant tumors of maxillary bone have be-en compared with equal effectiveness to other commonly employed methods.