Neck dissection on the left by <CLINICIAN_NAME>: Skin incision in the area of the apron flap, ending at the anterior edge of the sternocleidomastoid muscle, down to the tracheostoma edge. Cut through the subcutaneous tissue and identify the platysma. Dissection of the platysma and looping of the platysma. Subplatysmal dissection of the apron flap to expose the hyoid bone and the submandibular gland. Suturing of the apron flap and opening of the gland capsule in the caudal gland area. Dissection down to the hyoid bone. The marginal ramus of the facial nerve appears between the gland and the platysma and can be safely spared. Now expose the digaster venter posterior muscle and insert the Breitenbeck. Dissection of region II. Dissection along the sternocleidomastoid muscle down to the depths until the accessorius nerve is exposed, which is freed from the neck preparation. Dissection down to the deep plexus branches without damaging them. Identification of the omohyoid muscle in region III/IV and dissection along the muscle to the hyoid bone. Clearing of region III and IV. Sharp dissection on the internal jugular vein and freeing of the neck preparation from the vascular nerve sheath. This preserves all nerve and vascular structures. The lymph nodes are also removed from the posterior edge of the sternocleidomastoid muscle in the sense of a neck dissection in region V. Now resect the neck preparation in the usual way from cranial to caudal, sparing the deep plexus branches and the accessorius nerve. Enter the vessels medially and expose the common carotid artery, the carotid bifurcation, the superior thyroid artery and the facial artery. Now free the vascular nerve sheath from the larynx. Separate the infrahyoid musculature and strike the musculature downwards. Expose and remove prelaryngeal region VI. Identification of the hyoid bone and separation of the hyoid bone from the suprahyoid musculature. Neck dissection on the right by <CLINICIAN_NAME>: Exposure of the anterior edge of the sternocleidomastoid muscle and dissection in depth. Exposure of the omohyoid muscle and the submandibular gland. The submandibular gland is pulled upwards with the Langenbeck to protect the marginal ramus. Exposure of the posterior venter of the digastric muscle and of region II. A large metastasis can be seen in region II b, which extends to the mandible, displaces the accessorius nerve and is also attached to the internal jugular vein. This is carefully and successively dissected away, sparing all these structures. Exposing the cervical vascular sheath and exposing the lymph nodes from region II to IV. Finding the hypoglossal nerve and protecting it. Securing the vagus nerve and protecting it. Now clear the lateral neck preparation in the sense of a neck dissection from region II to IV. Region V at the posterior margin of the MSCM is also exposed and cleared while preserving the brachial plexus. Now clear the medial neck preparation up to region VI prelaryngeally. Detach the prelaryngeal musculature from the larynx and expose the hyoid bone using an electric knife. Release of the larynx on the right side. A thyroid gland can no longer be identified in the inflammatory tissue if the tracheostoma is clearly scarred. The tissue is removed to ensure good epithelialization of the tracheostoma. TSH, T3 and T4 checks should be carried out postoperatively. Laryngectomy by <CLINICIAN_NAME>: After completion of the bilateral neck dissection, detachment of the internal carotid artery from the hypopharynx on both sides. Firstly, separation of the larynx under the cricoid cartilage. Then expose the pre-epiglottic fat body and dissect the lingual epiglottis cranially up to its free edge. There it enters the hypopharynx. Now the larynx is successively released under visualization of the predominantly intralaryngeal tumor. The piriform sinuses, which were previously released, can be spared. The two lateral resections are combined caudal to the two arytenoid humps so that the larynx can now be completely removed. Circular mucosal samples are taken from the resulting defect in the pharynx, all of which are found to be tumor-free on frozen section histology. The myotomy is then performed. At the patient's request, a Provox device is not used. The T-shaped closure of the neopharynx is then performed using a first continuous suture according to Conley. The second layer is a single button suture. Redon suction drains are then inserted on both sides, the epithelialized tracheostoma is completed and the wound is closed in several layers on both sides.