Fabrication of a Provisional and Immediate Nasal Prosthesis Following Rhinectomy: Case Report of a Protocol
摘要
Patients undergoing rhinectomy often experience significant functional and psychological distress due to facial disfigurement. An immediate provisional nasal prosthesis can provide aesthetic restoration during the healing period before definitive reconstruction or prosthesis fabrication.
Materials and MethodsA presurgical facial impression was obtained prior to rhinectomy. Necessary trimming of the nasal profile was carried out on the facial moulage. A wax sculpture replicating the desired nasal form and profile was created on the model. This wax sculpture was duplicated using an elastomeric impression material to prepare a master cast, from which a vacuum-formed provisional nasal prosthesis was fabricated. The prosthesis was placed intraoperatively and secured to the surrounding skin using stay sutures. A second mold of the wax sculpture was prepared for fabrication of a definitive interim prosthesis. Preoperative skin color matching was performed, and medical-grade room temperature vulcanizing (RTV) silicone was processed using this mold.
ResultsThe initial vacuum-formed prosthesis was worn by the patient for 72-h postoperatively. After this period, a silicone interim nasal prosthesis was delivered, which could be worn daily and retained using adhesive tapes. This approach provided an immediate cosmetic solution and allowed for easy remaking of the prosthesis during the healing phase.
ConclusionThe described protocol enables the fabrication of an immediate provisional nasal prosthesis using preoperative facial impressions. This method offers psychological support, facilitates social reintegration, and improves the patient’s quality of life during the postoperative healing period following rhinectomy.