Introductory consultation with the anesthetist. Then exposure of the tumor in the area of the lateral pharyngeal wall using the spreading laryngoscope. The tumor can be sufficiently exposed. The tumor begins in the area of the lateral pharyngeal wall, extends to the entrance of the piriform sinus and via the pharyngoepiglottic plica to the epiglottis. Cutting around the tumor with the laser, whereby exposure during preparation is difficult. The tumor is resected with the lateral pharyngeal wall and the pharyngoepiglottic plica. To ensure safe resection, a portion of the large hyoid horn is also resected from the inside. Careful hemostasis. As far as can be assessed intraoperatively, the resection is successful in healthy tissue. Two marginal samples are taken, which confirm the resection in healthy tissue in a frozen section. Repeated hemostasis. Dry conditions. Repositioning of the patient. Application of local anesthesia in the area of the right neck. Abjode and cover the surgical area. Skin incision starting from the mastoid, along the anterior edge of the sternocleidomastoid muscle to the clavicle. Cut through the subcutaneous tissue. Exposure of the auricularis magnus nerve. Cranial displacement and re-embedding of the nerve in the sense of neurolysis at the end of the operation. Exposure of the sternocleidomastoid muscle. Exposure of the vascular nerve sheath with V. jugularis interna, A. carotis communis, A. carotis interna/externa, N. vagus, N. hypoglossus. Visualization of the accessorius nerve. Displacement of these structures during dissection and re-embedding in their original bed at the end of dissection. The lymphatic and connective tissue in the area of levels II to V is completely removed. In the area of level V, large lymph nodes are visible, which obviously merge into a thoracic duct. A caudal ligation is made here to avoid chyle flow. This results in a modified radical neck dissection on the right side, which comprises levels II to V. Careful hemostasis. Insertion of a Redon drain. Wound closure in layers. Application of a pressure dressing. Repositioning of the patient. Application of local anesthesia above the larynx and the cervical trachea. Transverse skin incision. Cut through the subcutaneous tissue. Exposure of the infrahyoid musculature. Exposure of the linea alba. Dissection of the cricoid cartilage and the trachea. Exposure of the thyroid isthmus. Dissection of the thyroid isthmus and exposure of the anterior wall of the trachea. Careful dissection of the trachea and performance of a small tracheotomy between the second and third tracheal rings. Epithelialization of the tracheostoma. Insertion of the tracheal cannula. Wound closure. Application of wound dressing. Final consultation with the anesthetist. The patient is transferred to the intensive care unit.