Procedure performed: Right vocal fold resection with frozen section and modified radical right neck dissection in ITN Surgeons: <CLINICIAN_NAME>, <CLINICIAN_NAME>, PJ student After definitive histology confirmed a squamous cell carcinoma of the right tonsil, the above procedure was performed. After consultation with the pathology department, the tumor is removed in depth in healthy tissue. Taking into account the marginal specimen, a tumor in the caudal and lateral region is still questionable. The marginal samples were found to be clear, but to be on the safe side, a resection was performed and sent in for a frozen section. This revealed a carcinoma in situ in the area of the base of the tongue. After receiving the frozen section, another resection is performed and a new marginal sample is taken. This is now found to be tumor-free. Hemostasis with H202 and bipolar coagulation. Repositioning for neck dissection on the right: infiltration anesthesia and skin incision from the infraauricular to the jugulum. Dissection of the subcutaneous tissue, exposure of the external jugular vein, ligation and transection of the same. Exposure of the auricular nerve, which can be preserved. Deeply incise the sternocleidomastoid muscle, expose the anterior border, dissect the muscle. A large lymph node package is found directly below the muscle; at least 6-7 lymph nodes are clearly pathologically enlarged here. These adhere relatively firmly to the jugular vein. Nevertheless, the vein can be carefully separated from the lymph node package in a healthy layer. The vagus nerve is also visualized. Dissection of the digastricus venter posterior muscle, here too the nodes are already firmly attached. Part of the muscle must also be removed to completely loosen the nodes. Finally, exposure of the accessorius nerve, free dissection of the same. Exposure of the accessorius triangle, lymph nodes here too. Dissection down to the muscle and removal of all lymph nodes in the accessorius triangle, further dissection caudally to supraclavicular. Dissection relatively far caudally, as lymph nodes are still altered here too. Before cutting through the neck preparation, it is ligated and repositioned several times to prevent a chyle fistula. Finally, further dissection of the external and lower common carotid artery, exposure of the hypoglossal nerve, the cervical artery, which must be severed as the nerve runs directly through the nodes. Removal of the entire lymph node package anteriorly, taking the capsule of the submandibular gland with it. Finally, all nodes can be removed macroscopically in toto. In the posterior part of the neck in particular, other nodes had also been removed in depth under the sternocleidomastoid muscle. Hemostasis with H202 swabs. Hemostasis with H202 and aqua. Removal of all swabs, no more bleeding. Another supraclavicular check, no evidence of chyle fistula, insertion of a Redon drain, subcutaneous suture. Skin suture. Wound dressing. At the end of the operation, the tonsil region was adjusted again, the swabs were also removed, no bleeding. Summarized findings: T2 tonsillar carcinoma, resection in sano, at least N2b status, questionable extracapsular extension, wait for pathological findings.