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Oculofacial Prosthetic Rehabilitation Complemented With Temporary Fillers and Neurotoxin
Nathalia Gusmão Prado Schnorr1, Rodrigo Salazar-Gamarra, Daniela Cortizo Latuff
1Paulista University (UNIP), Sao Paulo, Brazil.
The Journal of Craniofacial Surgery
|June 27, 2022
Summary
Injectable cosmetic fillers like botulinum toxin type A, hyaluronic acid, and calcium hydroxyapatite can refine facial reconstructions for head and neck cancer patients. These treatments improve outcomes for oculofacial prostheses by addressing tissue loss and asymmetries.
Area of Science:
- Oncology
- Plastic Surgery
- Biomaterials
Background:
- Head and neck cancer surgery often results in significant tissue loss, leading to deformities and psychosocial distress.
- Reconstruction of orbital defects after exenteration typically requires prosthetic solutions, even with advanced plastic surgery techniques.
- Innovations like 3D scanning and extraoral implants enhance oculofacial prosthesis aesthetics, but tissue quality remains a challenge.
Purpose of the Study:
- To evaluate the adjunctive use of injectable cosmetic fillers prior to oculofacial prosthesis fabrication in oncologic patients.
- To assess the impact of botulinum toxin type A, hyaluronic acid, and calcium hydroxyapatite on tissue quality for improved prosthetic fit.
- To document the effects on facial rehabilitation and overall aesthetic outcomes in patients undergoing oculofacial prostheses reconstruction.
Main Methods:
- A prospective study involving 5 oncologic patients requiring oculofacial prostheses.
- Pre-prosthetic treatment with botulinum toxin type A, hyaluronic acid, and calcium hydroxyapatite to address tissue deficits.
- Photographic documentation and observational analysis of tissue improvements, prosthesis planning, and rehabilitation outcomes.
Main Results:
- Injectable fillers effectively improved facial asymmetries, volumized surgical depressions, and softened atrophic scars.
- These treatments facilitated the creation of smaller, thinner, and better-fitting oculofacial prostheses.
- Temporary effects necessitate repeat applications but enhance procedural safety and allow for continued cancer monitoring.
Conclusions:
- Injectable cosmetic adjuncts offer a valuable method for refining tissue beds before oculofacial prosthesis manufacturing.
- This approach can significantly enhance the aesthetic and functional outcomes of prosthetic rehabilitation in head and neck cancer survivors.
- While generally safe, potential limitations include infection and necrosis risks in irradiated tissues, requiring careful patient selection and monitoring.
