Prosthetic rehabilitation of an orbital defect for a patient with hemifacial atrophy

Abstract

Removal of an eye may be indicated in cases of congenital abnormality, severe trauma, or disease such as an infection, tumor, or malignancy. The disfigurement associated with a loss of an eye is often accompanied with physical problems, psychological trauma, and a poor quality of life. A prosthetic replacement is the treatment of choice to return the individual to his normal vocation by producing an acceptable and life-like appearance. This article describes prosthetic rehabilitation of a 19-year-old male suffering from facial hemiatrophy with the loss of his left eye due to retinoblastoma when he was 2-year-old using medically graded silicone material. The technique used is simple, cost effective, and easy way for fabrication and rehabilitation of an orbital defect using silicone prosthesis where retention is achieved by a combination of silicone adhesives and tapes, and to a very small extent by bony and soft tissue undercut, hence providing better esthetic and psychological outcome. The acrylic part of the prosthesis was adhered to the socket with the help of a two-way silicon adhesive tape. Since the patient had lost his eye when he was 2-year-old, the development of eye and periorbital tissue on the defect side lead to hemiatrophy; in our approach, we have attempted to build the prosthesis in par with the normal side so that the fullness on the defect side was restored to that of the contralateral side. The fabricated facial prosthesis was durable, esthetic, and had good retention.

Keywords: Adhesives; facial hemiatrophy; orbital prosthesis; retinoblastoma; silicones.

Figure 1

Frontal view of the defect

Figure 2

Facial moulage reinforced with plaster of paris

Figure 3

Anophthalmic socket aperture blocked out

Figure 4

Heat-cured base of acrylic resin

Figure 5

Trial positioning of the prosthesis (a) frontal view, (b) lateral view

Figure 6

Sculpted prosthesis with the duplicated cast was flasked

Figure 7

Dorsal view of finished prosthesis with eyelashes

Figure 8

Orbital rehabilitation (final outcome with patient wearing regular powered spectacle)