title: Ateriovenous subclavia-shunt for head and neck reconstruction.
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 methods. 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.
authors.affiliation: Heinrich-Heine-University Duesseldorf, Department of Cranio- and Maxillofacial Surgery, Moorenstr 5, 40225 Duesseldorf, Germany. depprich@med.uni-duesseldorf.de
authors.forename: Rita A
authors.initials: RA
authors.lastname: Depprich
authors.forename: Christian D
authors.initials: CD
authors.lastname: Naujoks
authors.forename: Ulrich
authors.initials: U
authors.lastname: Meyer
authors.forename: Norbert R
authors.initials: NR
authors.lastname: Kübler
authors.forename: Jörg G
authors.initials: JG
authors.lastname: Handschel
mesh_terms: D001166:Arteriovenous Shunt, Surgical / Q000379:methods*; D002294:Carcinoma, Squamous Cell / Q000534:rehabilitation / Q000601:surgery; D006801:Humans; D008297:Male; D055806:Microvessels; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000534:rehabilitation / Q000601:surgery; D037981:Neck Dissection / Q000534:rehabilitation*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012501:Saphenous Vein / Q000637:transplantation; D013348:Subclavian Artery / Q000601:surgery; D013524:Surgical Flaps / Q000098:blood supply*