Objective: To investigate the application of the anterolateral thigh flap（ATF） and the forearm flap（FF） in soft tissue defect repair and reconstruction after tongue cancer surgery. Methods: A retrospective analysis was performed in 66 patients who had undergone soft tissue defect repair after tongue cancer in our hospital from December 2010 to December 2017. Among these patients

26 received FF repair（group A）

and 40 received ATF repair（group B）. The two groups were compared for vascular crisis incidence and survival rate of flaps

function and cosmetic effect of recipient sites

and complication incidence of donor sites. Results: In group A

the FFs in all of the 26 cases survived（100% survival rate）; vascular crisis occurred in 1 case

and the flap healed after removal of the thrombus at the vascular anastomosis site by surgical exploration. In group B

39 out of the 40 ATFs survived; 2 cases had a submandibular leakage infection on the fifth day after surgery

and healed after dressing change; of 2 cases who had vascular crisis of the flaps

1 received anastomosis of two veins and the flap survived; the other had flap necrosis and FF repair was performed. Between the two groups

there were no significant differences in vascular crisis incidence

flap survival rate

and function and cosmetic effect of repaired defective areas（P > 0.05）. Compared with group B

group A had a significantly higher incidence of pigment deposition

dysfunction

and complications in the donor sites（P < 0.05）. Conclusion: Both the FFs and the ATFs have shown a good effect in soft tissue defect repair after tong cancer surgery. The FF repair yields a higher degree of satisfaction with speech and swallowing functions in patients with partial tongue or half tongue defect. By contrast

the ATF repair has fewer complications in the donor sites and more flexible ways of designs

making ATFs a more ideal choice for patients undergoing repair and reconstruction after tongue cancer surgery.