Head & Face Medicine (Nov 2008)

Ateriovenous subclavia-shunt for head and neck reconstruction

  • Kübler Norbert R,
  • Meyer Ulrich,
  • Naujoks Christian D,
  • Depprich Rita A,
  • Handschel Jörg G

DOI
https://doi.org/10.1186/1746-160X-4-27
Journal volume & issue
Vol. 4, no. 1
p. 27

Abstract

Read online

Abstract Reconstruction of the facial hard- and soft tissues is of special concern for the rehabilitation of patients especially after ablative tumor surgery has been performed. Impaired soft and hard tissue conditions as a sequelae of extensive surgical resection and/or radiotherapy may impede common reconstruction methodes. Even free flaps may not be used without interposition of a vein graft as recipient vessels are not available as a consequence of radical neck dissection. We describe the reconstruction of the facial hard- and soft tissues with a free parasacpular flap in a patient who had received ablative tumor surgery and radical cervical lymphadenectomy as a treatment regimen for squamous cell carcinoma (SCC). To replace the missing cervical blood vessels an arteriovenous subclavia-shunt using a saphena magna graft was created. Microvascular free flap transfer was performed as a 2-stage procedure two weeks after the shunt operation. The microvascular reconstructive technique is described in detail.