Reconstruction of the exenterated orbit with osseointegrated implants

Osseointegrated implant-fixated prostheses are useful for the reconstruction of the exenterated orbit. They provide good cosmesis, and are comfortable and light weight for the patient to wear. A retrospective review was performed of a series of twenty patients who had undergone orbital exenterations from 2003 to 2006, including complex cases with extraorbital and transcranial tumour excisions, nineteen of which were reconstructed with osseointegrated implant-fixated prostheses. For a successful outcome, decisions need to be made regarding the reconstruction of the orbital rim, periorbital soft tissues, indications for socket reconstruction and decisions regarding both one or two stage implantation and radiotherapy planning. Osseointegrated implants provide the optimal cosmetic and functional results in the rehabilitation of the exenterated orbit in our opinion. Close collaborative planning by both the surgeon and the prosthetist from the outset is essential.