The clinical application of the peroneal artery perforator flap in the reconstruction of tissue defect in maxillary malignant tumor resection

Objective To evaluate the clinical effect of application of free peroneal artery perforator flap in repairing postoperative tissue defect after resection of oral maxillary malignant tumor. Methods From January, 2016 to June, 2018, 14 patients with maxillary malignant tumor were treated with tumor excision. Then the free peroneal artery perforator flap was used to reconstruct tissue defect caused by tumorectomy. There were 6 cases of squamous-cell carcinoma of palatine, 2 cases of adenoid cystic carcinoma of palatine, and 6 cases of maxillagingiva squamous cell carcinoma. The incised area of flap was 4.0 cm×5.0 cm to 7.0 cm×8.0 cm. There were 5 cases of hard palate soft tissue defect repair and 9 cases of simultaneous repair of soft and hard palate. Followed-up by outpatient service in 3-12 months after operation, postoperative maxillamorphology, phonetic function, swallow function, opening degree and prognosis of the patients were evaluated. Results All 14 implanted flaps were alive. One flap had vascular crisis, and rescued by surgical exploration and timely rescue. Three flaps were prolonged healing. All donor sites were sutured directly. All surgical incisions healed primarily. Half a year after the operation, the appearance of maxilla was formed gradually. The phonetic function, swallowing function, opening degree and movement of lower leg were all recovered normal. One year after the operation, epithelization was done in 6 cases. And there was no tumor recurrence. Conclusion The peroneal artery perforator flap has long vascular pedicle, larg diameter, high survival rate after vascular anastomosis and relatively concealed donor area. It can be used to repair and reconstruct the tissue defect in maxillary malignant tumor resection and achieved good result. Key words: Peroneal artery perforator flap; Maxillary malignant tumor; Soft tissue defect; Reconstruction