頭頸部再建外科における胸鎖乳突筋皮弁の応用（続報）

Use of the Sternomastoid Myocutaneous Flaps for Reconstructive Surgery of the Head and Neck

I．はじめに

　胸鎖乳突筋皮弁（SM弁）はOwens（1955）^1）が頭頸部再建外科に初めて応用し，その後いくたの報告^2〜11）がみられる。筆者ら^12）もその経験をすでに報告した。今回はSM弁の生着の観点から経験を整理し，弁の栄養動脈流を検討した。

　The sternocleidomastoid myocutaneous flap was used for reconstruction of surgical defects in 12 patients with oral or mesopharyngeal cancers, and four patients developed partial necrosis of the flaps and one extensive.

　The necrosis was not related to the factors such as preoperative irradiation, use of island flap, combination of functional neck dissection, the sizes of defect to be reconstructed and widthlength ratio of the flaps. On the other hand, necrosis of the flaps was more frequent in the left neck than that in the right.

　Arterial blood flows of the flap were examined by means of cadaver dissection, dye infusion through the branches of irrigating arteries and the measurement of blood flow by the hydrogen gas clearance method. The blood flow of the lower half of the flap was supplied from branches of the superior thyroid and thyrocervical artery.

　In conclusion, when the upper based flap was used, the branches of superior thyroid artery should be preserved, while the flap from the left neck, careful surgery is necessary to preserve the arteries.