Nasal prosthesis for a patient with xeroderma pigmentosum
A 15-year-old girl was referred to the department of prosthodontics from Otorhinolaryngology Department, Chennai medical College, for nasal prosthesis. Patient had undergone a partial rhinectomy as a treatment for BCC of nose. The bridge of the nose and nasal bone was included in the resection []. Surgical reconstruction and various prosthetic rehabilitation techniques were discussed, general medical complexity of surgical reconstruction such as inward tissue constriction, collapse of tissues and patient refusal to undergo surgery lead to this method of rehabilitation.\nA silicone nasal prosthesis retained using a spectacle glass frame was decided as a treatment plan. The boundary for the impression was outlined on patient face. Necessary precautions taken and a moist gauze was packed to prevent the flow of the material in to the undesired areas of defect, an impression was taken of the defect together with the adjacent tissue, using an irreversible hydrocolloid impression material (Algitex; DPI, Mumbai).\nThe impression was removed, poured with type III dental stone (Kala Stone; Kala Bhai Pvt. Ltd., India). The model prosthesis was sculpted on the facial cast with no. 2 wax (MDM Corporation, India) []. The wax pattern was then tried on to the patient face, it was checked especially in the border areas and the pattern was reviewed to assess the potential areas for prosthesis retention. Tissue texture and relevant contours were evaluated on the face of the patient [].\nFlasking and dewaxing done. Patients skin tone was used as a guide to match the prosthesis. The silicone material mixed with intrinsic colors on a ceramic slab and compared with patient's skin color tone. The mold was then packed with the prepared material and processed according to the manufacturer instructions. After deflasking, the prosthesis was evaluated on the patient and some extrinsic water resistant coloration was added to make the prosthesis more realistic [].\nAfter the final contouring and matching, the prosthesis was attached to the glass frames []. The eye glasses were used to maximize the retention and to improve the esthetic appearance of the patient. The placement of the prosthesis was demonstrated to patient. Patient was scheduled for the first post-insertion adjustment 1 day after the insertion to ensure the health of the tissues and to relieve any pressure areas on the tissues. Patient was then asked to come for recall visit once in every 3 months for evaluation of prosthesis and observation of any recurrence.