First consultation with the anesthetist. Then advance the 0° telescope through the glottic plane into the trachea. Inconspicuous mucosal conditions in the area of the trachea. Further advancement of the endoscope into the bronchial system on both sides. Inconspicuous mucosal conditions here. The bronchi are inspected up to the exit of the segmental bronchi. Now infiltrate the patient. There are no abnormalities in the glottis, subglottis and supraglottis. There are also no special features in the hypopharyngeal region on both sides or in the postcricoid region. Raising of the soft palate. Inspection of the nasopharynx: No special features here either. Now advance the flexible telescope into the stomach. Careful mirroring back. No special features in the area of the esophagus. Inspection of the oropharynx: Normal findings in the area of the oropharynx on the right side. No changes to the mucosa in the area of the tonsil or in the area of the right base of the tongue. Now inspection of the oropharynx on the left side. There is a clear induration of the tonsil in the area of the lower half, which corresponds to the CT findings. The tumor borders on the base of the tongue, but does not merge into the base of the tongue. Final inspection of the oral cavity. Inconspicuous mucosal conditions. All inspections with the aid of the endoscope or microscope. Now adjust with the tonsil retractor and expose the tumor. Now wide incision of the tonsil in the sense of a tumor tonsillectomy. Dissection towards the base of the tongue. In the area of the base of the tongue, remove the tissue adjacent to the tonsil. The tumor, which can be clearly defined by palpation, is incised in the healthy area, whereby the mucosa is also resected up to the middle of the pharynx. The tumor is removed in the area of the base of the tongue with careful hemostasis. The specimen is marked and sent as a whole for frozen section histology. <CLINICIAN_NAME> diagnoses the tonsil as the primary tumor on the one hand and a clear resection of the tumor in healthy tissue on the other. Careful hemostasis in the oropharynx area again. Insertion of a gastric tube. Repositioning of the patient. Abjode and cover the left neck. Then application of local anesthesia. Now skin incision from the mastoid to the clavicle. The scar made during the previous operation is included in the incision. Now cut through the subcutaneous tissue and cut through the platysma. In view of the previous operation, which took place 12 days ago, extremely difficult dissection conditions, particularly in the area of levels I, II and III. The tissue here is clearly caked. Exposure of the internal jugular vein. Exposure of the common carotid artery, exposure of the internal and external carotid artery, exposure of the branches of the external carotid artery. Visualization of the hypoglossal nerve. Visualization of the vagus nerve. Exposure of the accessorius nerve. Due to the previous operation, there is a pronounced conglomerate in the area of the upper venous angle. This conglomerate cannot be safely separated from the internal jugular vein under oncological aspects, so that a radical neck dissection, in the sense of a resection of the internal jugular vein, is performed. Separation of the internal jugular vein cranial to the inflow of the thyroid vein and dissection cranially. Exposure of the hypoglossal nerve. Separation of the internal jugular vein below the base of the skull. Dissection of the facial vein and removal of the tumor conglomerate in the area of levels I, II and III. Now dissection in the area of levels IV and V after exposing the accessorius nerve and exposing the deep neck muscles and the phrenic nerve. The resection extends below the omohyoid muscle. This results in a radical neck dissection, whereby levels Ia, II, III, IV and V are included in the resection. Repositioning of the above-mentioned structures, which were removed from their beds during neurolysis and are repositioned in their beds at the end of the operation (vagus nerve, hypoglossal nerve, accessory nerve, common carotid artery, internal carotid artery, external carotid artery). Rinse the neck with water and hydrogen. Careful hemostasis. Insertion of a Redon drain. Wound closure in layers. Now re-inspect the oral cavity. The resection bed is dry and free of irritation. Final discussion with the anesthetist, in the sense of a consultation. The patient is transferred to the recovery ward.