A Simplified Approach to Fabricate a Hollow Ocular Prosthesis

Surgical Rehabilitation of a Continuous Orbital and Maxillary Defect from Rhino-Orbital Mucormycosis Utilising Digital Technology - A Case Report

Rationale

COVID-19 has led to a resurgence in cases of mucormycosis, especially the rhino-orbital form affecting the oral cavity, nasal, orbital and cerebral regions.

Patient Concerns

The surgical treatment in this patient led to the exenteration of orbital contents and segmental maxillectomy of the affected side leading to facial disfigurement and inability to masticate.

Diagnosis

A combined mucormycosis-associated oro-orbital defect was present leading to a communication between oral and orbital cavities.

Treatment

Rehabilitation utilising digital technology for removable prosthesis was planned for the combined orbital and oral defect.

Outcomes

The independent intraoral and orbital prosthesis reduced the mobility of the orbital prosthesis while performing functional movements. The advancements in digital technology led to the convenient and resilient fabrication of prostheses for large facial defects.

Take-away Lessons

The prosthetic rehabilitation of a continuous orbital and oral defect with a hybrid of both digital and conventional means provided an aesthetic, feasible and financially sound solution to the patient.

The art of managing various ocular defects in different clinical scenarios: A case series

The absence of eye and irradiation post-enucleation may result in problems like dryness of the eye sockets, itching and crusting. This may lead to poor prosthesis adaptation and a lack of patient acceptance of the prosthesis. To combat the most common problem of dryness, patients are advised artificial tears to use as teardrops or ocular prostheses along with a tear reservoir. This case series describes methods of fabricating ocular prosthesis indicated in different scenarios: the modified stock ocular and a custom-made ocular prosthesis when tearing secretion is enough in the eye socket and an ocular prosthesis with a tear reservoir in cases showing reduced tear secretion. A novel technique of fabricating hollow lightweight ocular prostheses having the sustained prolonged release of artificial tears has been described.