ObjectiveTo explore the clinical application of free anteromedial thigh chimeric myocutaneous perforator flap in the reconstruction of tongue defect after radical resection of tongue carcinoma．MethodsFrom June 2015 to Nov 2018，14 cases with tongue carcinoma underwent radical resection with tongue and mouth floor defects reconstructed by free anteromedial thigh chimeric myocutaneous perforator flaps at the same stage．Defects after resection with size ranged from 6.0 cm×4.0 cm to 12.0 cm×7.0 cm were reconstructed by free anteromedial thigh chimeric myocutaneous perforator flaps with skin paddle size ranged from 8.0 cm×4.0 cm to 13.0 cm×8.0 cm and muscular segment ranged from 4.0 cm×3.0 cm×2.0 cm to 7.0 cm×5.0 cm×4.0 cm. All the arteries of the perforators were anastomosed with superior thyroid arteries, while the accompanying veins were anastomosed with superior thyroid veins or internal jugular veins.ResultsThe perforators existed consistently in all cases. The perforator originated from femoral artery in 7 cases (50%) with an average pedicle length of (7.8±0.4) cm, from lateral femoral circumflex artery in 4 (28.6%) with an average pedicle length of (8.2±0.5) cm, and from descending branch of lateral femoral circumflex artery in 3 (21.4%) with an average pedicle length of (7.4±0.3) cm. Rectus femoris muscular flap was harvested in 8 cases, and vastus medialis muscular flap was harvested in 6. The pedicle vessels contained 1 artery and 2 accompanying veins in 8 cases, 1 artery and 1 accompanying vein in 6, and the superior thyroid vein was the first choice of recipient vein. The first accompanying vein of perforator artery was anastomosed endtoend with superior thyroid vein in 14 cases, while the second accompanying vein was anastomosed endtoside with internal jugular vein in 8 cases. All flaps survived uneventfully 2 weeks after operation, and the wounds healed smoothly. All patients were followed up for 12 to 40 months after operation (18.8 months on average). The repaired sites were not bulky in appearance, with twopoint discrimination distances ranged from 8 to 15 mm. The movement of tongue was not affected, and patients could speak and eat normally. The function of thigh was not affected obviously, and patients could walk normally and do related daily activities.ConclusionThe free anteromedial thigh chimeric myocutaneous perforator flap is an idea choice to reconstruct the tongue defect after radical resection of tongue carcinoma．