Initially induction of anesthesia and transoral endotracheal intubation by the anesthesia colleagues and positioning of the patient by the surgeon. Placement of the Mc Ivor spatula in the oral cavity and inspection. This revealed a slightly enlarged, otherwise unremarkable tonsil on the left side. Parauvular incision. Exposure of the tonsil capsule. Treatment of the upper pole using bipolar coagulation. Preparation from cranial to caudal, non-irritating conditions, good preparation conditions. The lower pole of the left tonsil can be removed without difficulty. The specimen is sent for intraoperative frozen section examination, which is assessed by the pathology colleagues and results in the diagnosis of HBV-positive squamous cell carcinoma of the left tonsil. The decision was made to perform a modified radical neck dissection on the left side. Application of local anesthesia cervically on the left, skin ablation and sterile draping. Creation of a modified, curved skin incision. Dissection of the subcutaneous tissue of the platysma and exposure of the auricular nerve and protection of the same. Exposure of the accessorius nerve in depth, the omohyoid muscle, the digaster muscle (venter posterior) and the capsule of the submandibular gland. First, the mass is bypassed in the sense of a capsular dissection and removed without difficulty. Then dissect along the cervical vascular sheath from caudal to cranial and expose the internal jugular vein of the vagus nerve and the common carotid artery. Exposure and sparing of the plexus branches, successive evacuation of regions Ib, IIa, IIb, III, IV and Va while sparing the above-mentioned structures. Removal of the anterior neck specimen. Hemostasis by means of bipolar coagulation. Dry conditions. Irrigation of the wound using hydrogen peroxide and Ringer's solution. Placement of a 10-gauge Redon drain. Two-layer wound closure. Application of a pressure dressing. Completion of the procedure without complications. In case of unclear findings regarding the margin situation during the intraoperative frozen section examination and otherwise almost R0 situation in all margins. Decision to take 3 margin samples (cranial, lateral, caudal), which are sent for final histology. Repeated inspection. Dry conditions, removal of the Mc Ivor spatula. Placement of a nasogastric feeding tube in the typical manner. Completion of the procedure without complications. Please feed for 7 days via the inserted nasogastric feeding tube. After that, careful diet build-up. Suture removal on the 8th postoperative day and prompt presentation at our interdisciplinary tumor conference to plan further therapy.