๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
Technique
Technique
Incisions are marked from the lateral canthal angle to extend laterally and vertically following the curve of the eyelid. At the apex, the mark begins curving downward forming a semicircle. The average diameter of the semicircle is approximately 1 to 2 cm and in practice may not be a true semicircle. A skin incision is made with a #15 scalpel blade, initially following only the lateral and vertical curves of the Tenzel flap. The flap can be extended later if required. The firm attachment of the lower lid is released with a canthotomy passing through the inferior crus of the lateral canthal tendon with Westcott scissors. The scissors are then used to make a pocket on each side of the septum, and then with the lid under medial tension use the tip of the scissors to feel for the tight septal fibers by drumming across them. The cantholysis is then progressively increased until the wound can be easily closed. Care is taken not to disrupt the upper limb of the canthal tendon. The flap is then rotated and sutured into place and the primary defect closed using the standard diagonal tarsal suture technique. A canthal suspension suture is sometimes placed at the lateral canthus to provide additional support. As the lateral Tenzel flap is pulled medially, it usually closes automatically, and often only a small number of interrupted sutures are required to close the skin.