Arch Craniofac Surg.  2020 Feb;21(1):35-40. 10.7181/acfs.2019.00577.

Reconstruction of periorbital defects using a modified Tenzel flap

• Cha JA
• Lee KA

• KMID: 2501085
• DOI: http://doi.org/10.7181/acfs.2019.00577

Abstract

Background
Extensive eyelid defects are extremely challenging to reconstruct. Although numerous procedures for reconstructing periorbital defects have been proposed, no method is universally used. However, the Tenzel flap is the most commonly used technique to reconstruct eyelid defects affecting one-third to two-thirds of the eyelid.
Methods
Recognizing the usefulness of the Tenzel method, we adapted it to reconstruct larger defects around the eyes. Seven patients underwent reconstruction with a modified Tenzel flap with an extended concept after wide excision of a malignant skin lesion. The main difference from the conventional method is that the modified Tenzel flap includes the medial portion of the lower lid defect. The design of a modified Tenzel flap begins as a semicircle at the lateral canthal area, in the same way as a classical Tenzel flap, and extends medially along the subciliary line to cover the defect on the medial lower eyelid. The follow-up time ranged from 3 to 28 months.
Results
All flaps survived and healed well, with minimal scarring and natural palpebral outlines.
Conclusion
Compared to traditional procedures, the modified Tenzel flap has several advantages, including a one-stage operation, a less noticeable scar, and effective prevention of complications such as lower eyelid ectropion.

Keyword

Eyelids; Skin neoplasms; Surgical flaps