After induction of anesthesia and intubation by the anesthesia colleagues, positioning of the patient. First, a pharyngo-laryngoscopy is performed again. With the Kleinsasser tube, the oral cavity is inconspicuous, the tonsillolarynx is inconspicuous, the hypopharynx and endolarynx are inconspicuous and there are slightly hyperplastic conditions in the area of the right tongue base as described above; on the left side, inspection reveals a lesion measuring just under 1 cm at the transition from the tongue base to the pharyngeal side wall, which is somewhat contact vulnerable. Under microscopic examination, impression of a superficial ulceration. Adjustment of the lesions with the Steiner tube. Subsequent resection of the lesion with the 5 Watt CO2 laser in superpulse mode. Free conditions in depth with regular and intact musculature. Macroscopic resection in sano of the barely visible lesion. Absolute blood dryness. The resectate is now sent for frozen section diagnostics with the question of the blind biopsied primary. The invasive carcinoma is found to be tumor-free at all edges in the frozen section and thus resected R0. However, due to the non-oriented specimen, definitive representative margin samples are then taken. Careful hemostasis with absolutely dry and slim mucosa. Completion of the procedure. In the meantime, the left neck revision was performed. Injection of xylocaine with added adrenaline at the caudal end of the scar with extension into the supraclavicular direction. Cut through skin and subcutaneous tissue. Exposure of the sternocleidomastoid muscle. Exposure of the omohyoid muscle and the internal jugular vein. Separate the sternal muscle insertion of the sternocleidomastoid muscle for better mobilization. The suspicious masses described above can now be clearly palpated. These are located partly between the clavicle and the omohyoid muscle, partly also in region V on the subclavian vein. Careful resection of the changes. The exact changes described sonographically with two masses measuring approx. 1 ˝ cm and a median 3rd mass can be extirpated. The two larger masses were also highly suspicious macroscopically. Careful palpation of the entire supraclavicular area, here no further masses. No evidence of lymphatic leakage. Careful hemostasis, wound irrigation with H202 and Ringer's solution and, in dry conditions, insertion of a 10-gauge Redon drain and careful two-layer wound closure. Conclusion: Intraoperative R0 resected cT1 tongue base carcinoma on the left with residual cN2b lymph node status on the left. Overall, adjuvant radiochemotherapy is certainly indicated and necessary here. The patient received a single shot of Unacid 3 g and 250 mg SDH intraoperatively.