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Figure 6: Digital subtraction angiography postembolization: The
Figure 5: Digital subtraction angiography identified an arteriovenous hypertrophic left occipital artery feeding the main A-V fistula was
malformation around the left ear occluded by 3 Guglielmi Detachable Coils (Target Therapeutics, Fremont,
California, USA). Anterior auricular artery branches supplying the
vascular nidus was embolized with Onyx Liquid Embolic System (Onyx
®
HD-500)

Figure 7: Preoperative design and marking of the cervicofacial rotation
flap

Figure 8: Intraoperative view after careful dissection of the facial nerve
and control of the neck vessels

Figure 9: Intraoperative view following excision of the vascular
malformation

Figure 10: Postoperative view after skin closure
blood flow, arterial occlusion and venous thrombosis,
endocrine, trauma, or iatrogenic insults such as incomplete Increased understanding of these additional physiologic
surgery and proximal embolization, and infection.
variants may help to define their clinical presentation
High flow in an existing VM can induce arteriovenous and evolution and assist in designing therapeutic
shunting, which, in turn, increases flow demand, strategies. The diagnosis is usually made based on
[6]
cascading enlargement of the malformation. clinical history and physical examination. Cross section

Plast Aesthet Res || Vol 1 || Issue 1 || Jun 2014 35