頭頸部悪性腫瘍進展例における筋皮弁を用いた一期的再建術

One-stage Reconstruction of Defect with Myocutaneous Flaps in Head and Neck Cancers

I．はじめに

　頭頸部悪性腫瘍摘出術後の再建術は近年めざましい進歩をきたしており，広範囲かつ安全に腫瘍部位を切除することが可能になった。と同時に形態と機能の保存といった点にも大きく貢献しており，とくに重要な機能が集中している頭頸部領域においてはその意義は大きい。

　今回われわれは，数年前までは根治的手術治療が困難と考えられたような腫瘍進展例も含め，筋皮弁（myocutaneous flap；以下M-C flapと略す）を用いて一期的に建を行い得た頭頸部悪性腫瘍の4例を経験したので報告し，若千の文献的考察を加えた。

　In four caces of advanced cancer, the surgical defects were reconstructed immediately after radical surgery, by application of myocutaneous flap with satisfactory result. Primary sites of tumor were the parotid gland, external auditory meatus, larynx and submandibular gland. Reconstruction was performed with pectoralis major myocutaneous island flap, latissimus dorsi myocutaneous free flap, latissimus dorsi myocutaneous island flap and serrates anterior osteomuscular free flap respectively.

　The use of myocutaneous flap in the repair of defects in head and neck contributes to preservation of the structure and function of the diseased region, and facilitates successful rehabilitation of patients with advanced cancers and a possibility of permanent cure.

　We believe that this innovitative surgical method can be expected to improve the final cure rate in advanced head and neck cancers.