First consultation with the anesthetist. Then rinsing of the mouth. Cleaning the oral cavity. Insertion of the blocker. Then incision in the area of the posterior third of the tongue and cutting around the tumor with a clear safety margin. Resection of the tumor in the area of the edge of the tongue. In the area of the glossotonsillar groove, dissection towards the anterior palatal arch and resection of the anterior palatal arch and parts of the tonsil. As far as can be assessed intraoperatively, the resection is completely sano. Careful hemostasis. Removal of circular margin samples, which are found to be tumor-free in the frozen section. The sublingual gland is exposed in a circumscribed manner, but remains intact. The tonsil is partially resected. Dry and clear conditions at the end of the operation. Now reposition the patient. Application of local anesthesia in the area of the left neck. Abjode and cover the surgical area. Then skin incision from the tip of the mastoid to the clavicle. Cut through the subcutaneous tissue. Exposure of the auricular nerve. Dissection of the auricular magnus nerve from its bed and displacement of the auricular magnus nerve. At the end of the operation, re-embedding of the auricular nerve in its old bed. Exposure of the sternocleidomastoid muscle. Exposure of the common carotid artery, the internal and external carotid artery, internal jugular vein. These structures are moved out of their beds and moved back at the end during the operation. Exposure of the accessor nerve, which is also freed from surrounding tissue and re-embedded in its bed at the end of the operation. Exposure of the vagus nerve and the hypoglossal nerve, which are also dissected out of their beds and re-embedded at the end of the operation. Now expose the caudal edge of the parotid gland. Exposure of the posterior venter of the digastric muscle. Careful dissection of the lymphatic and connective tissue while preserving the above-mentioned structures. This results in a modified radical neck dissection, which includes levels II, III and IV. Irrigation of the wound with water and hydrogen. Insertion of a Redon drainage. Wound closure in layers. Final discussion with the anesthetist in the form of a consultation. The patient is transferred to the recovery ward.