Oculo-facial rehabilitation after facial cancer removal

Abstract

Leaving open or closing the oculo-facial defect by means of a myocutaneous flap mainly depends on maxillofacial surgical considerations. For those cases that present a closed defect, the authors aim to evaluate an innovative method of ocular bulb positioning using a magnetic resonance imaging dataset. Following cancer removal and plastic reconstructive surgery, a Digital Imaging and Communications in Medicine format magnetic resonance imaging dataset was used to determine the volume and position of the left ocular bulb. The exact location of the prosthetic bulb was determined by mirroring this position on the affected side. Images of the eyeglasses were imported into the virtual environment, and the designs of the substructure and facial prosthesis were projected using computer-aided design/computer-aided manufacture (CAD/CAM) technology. The updated method presented here enables restoration with a facial prosthesis, even when a myocutaneous flap is used to close the defect, thereby resolving the problem of ocular bulb positioning and enabling the rapid and easy design of a retention system connected to eyeglasses. The proposed protocol aims to develop and describe a viable method for the construction of a facial prosthesis for a patient whose face had been reconstructed using a myocutaneous free flap.