gms | German Medical Science

77th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

24.05. - 28.05.2006, Mannheim

Cerebral high-flow bypass surgery as an adjunct to the interdisciplinary treatment of complex tumors of the head and neck

Meeting Abstract

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  • corresponding author Peter Vajkoczy - Neurochirurgische Klinik, Universitätsklinikum Mannheim, Mannheim
  • Karl Hörmann - Hals-Nasen-Ohren Klinik, Universitätsklinikum Mannheim, Mannheim

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 77. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V.. Mannheim, 24.-28.05.2006. Düsseldorf, Köln: German Medical Science; 2006. Doc06hnod600

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hnod2006/06hnod600.shtml

Published: April 24, 2006

© 2006 Vajkoczy et al.
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Outline

Text

A curative surgical treatment of head and neck tumors or central skull base tumors may necessitate the sacrifice of the common or internal carotid artery. However, a significant portion of patients will not tolerate this manoeuvre due to an inadequate collateral blood blow to the brain and, therefore, need a high-flow revascularization procedure for flow replacement prior to radical tumor removal. So far, however, high-flow bypass surgery using saphenous vein or radial artery grafts has been considered to be associated with an inacceptably high surgical risk and as a consequence incomplete tumor removal followed by adjuvant therapies has been preferred over an aggressive surgical approach. Recently, however, considerable progress has been made in patient selection, in individualizing and tailoring the revascularization procedure, and in developing surgical means to reduce the perioperative stroke risk. In this respect, the single most important innovation in high-flow bypass surgery is the development and clinical introduction of the Excimer Laser-assisted non-occlusive anastomosis technique which circumvents the need for temporary artery occlusion of cerebral blood vessels. The current presentation will report our recent experiences with these novel techniques in high-flow bypass surgery as well as our results in using high-flow bypass surgery in the treatment of complex aneurysms. Finally, the potential of high-flow bypass surgery for the interdisciplinary therapy of compex head and neck tumors will be discussed.