Prosthetic rehabilitation of a midfacial defect resulting from lethal midline granuloma--a clinical report

Prosthetic rehabilitation of the midfacial defects has always perplexed maxillofacial prosthodontists. These midfacial defects lead to functional and cosmetic deficiencies. One of the causes of such defects is midline lethal granuloma, which is a destructive granulomatous lesion of uncertain aetiology, involving the nose, paranasal sinuses and the palate. Presented here is a clinical report of a 22-year-old male patient diagnosed to have lethal midline granuloma, who was referred to the Department of Prosthodontics, SDM College of Dental Sciences Dharwad. The patient had a severe midfacial defect involving the nose, the paranasal sinuses, the palate and the soft tissues of the face. Although the lesion was not of the rapidly progressive type at the time of rehabilitation, the non-specific inflammatory process was persisting. The patient was treated with chemotherapy and palliative therapy. The primary objective of the prosthetic rehabilitation was to provide closure of the severe defect to protect the soft tissues from environmental exposure. Secondarily the prosthesis also provided acceptable aesthetics and psychological benefit to the patient.