A unique conjoined orbital and maxillary removable “Bottle opener” prosthesis for hemi-maxillectomy defect with orbital exenteration

Abstract

Introduction: A 79 year old Caucasian male underwent left sided extended hemi-maxillectomy and orbital excenteration for T4 N0 M0 poorly differentiated squamous cell carcinoma of the left maxillary antrum in 2003.He subsequently had left sided elective neck dissection for nodal disease and chemo radiotherapy. Initial rehabilitation included an adhesive retained orbital prosthesis with maxillary obturator and denture. He could not tolerate the eye prosthesis due to sensitivity over the bony ridges and elected to wear an eye patch instead. He only had two teeth in the right hemi-maxilla which were periodontally compromised and were therefore extracted. He had peri orbital implants for a bar retained orbital prosthesis. Due to his dementia he and his wife found it difficult to clean around the fixed prosthesis. Material and Methods: A removable connector was designed to incorporate a large multipurpose magnet (Technovent ®) for retention of obturator and the orbital prosthesis. This allows easy placement of orbital prosthesis followed by the obturator. The patient fondly calls this his “bottle opener”. Results: This has helped to solve both the defect obliteration and his dexterity issues for its maintenance. Conclusion: We describe and demonstrate a unique removable connector to make the hemi-facial prosthesis modular and removable. As far as our knowledge this modification is unique and not described in the literature