A lower lid basal cell carcinoma
involving the margin. The tumour was confirmed on punch biopsy. The defect
created will not allow direct closure. |
Marking of the tumour with
a 3 mm clear margin. The periorbital flap measures 22mm vertically and
17 mm horizontally. |
The upper lid is stretched to show
the exact marking of the periorbital flap. |
Following the tumour excision.
There is a 70% defect of the lower eyelid. |
The excised lesion is marked with
stitches of different length and sent for histology. |
The periorbital flap is created
by dissecting through the skin and the orbicularis. Cantholysis is performed
in the lateral canthus. |
The lid defect is sutured first
before the periorbital flap. Deep suture is used to attach the centre of
the flap to the underlying structure to prevent the formation of haematoma.
|
The final appearance of the Tenzel's
flap. |