Induction of anesthesia and intubation by the anesthesia colleagues. Entry with the small bore tube and inspection of the tumor. The tumor is located at the base of the tongue on the left side, passes over the glossotonsillar groove into the anterior palate and partly into the soft palate. Then insertion of the spandex and looping of the tongue. Now cut around the tumor with a safety distance of 1.5 to 2 cm using the monopolar needle. Further dissection with scissors, forceps and bipolar coagulation. Tumor resection is very difficult in the posterior sections of the base of the tongue due to a lack of visibility. Finally, the specimen is retrieved in its entirety. A suture mark is placed while still in situ. The specimen is then removed and inspected. There is a safety margin of approx. 1 cm in the entire preparation area. The specimen is placed on cork and sent for frozen section. In the frozen section, all margins are free of carcinoma, including no dysplasia or carcinoma in situ. There are large, palpable neck metastases on the left side, the border to the neck area can no longer be safely spared, therefore a neck dissection on the left side is dispensed with. The patient was not previously informed and prepared for a flap operation. Therefore, the neck dissection is now performed on the right side. Skin spray disinfection in the usual manner. Injection of 10 ml Ultracaine 2% with added Suprarenin in the area of the skin incision on the right. The skin incision corresponds to a curved line on the anterior edge of the sternocleidomastoid, starting below the mastoid to two transverse fingers above the clavicle, at least two transverse fingers on all sides away from the mandibular branch and the angle of the jaw. Then reposition the patient and wash and drape sterilely in the usual manner. Skin incision and sharp separation of the platysma and dissection along the anterior edge of the sternocleidomastoid muscle. Exposure of the accessorius nerve. Exposure of the posterior abdomen of the digaster muscle and the omohyoid muscle. Dissection along the cervical vascular sheath from caudal to cranial. Successive removal of the posterior and anterior neck specimen while protecting the accessorius, the cervical plexus and the hypoglossal nerve, which was exposed and spared. Overall, levels I b, II, III, IV and V were completely removed. The submandibular gland was left intact. Wound irrigation with hydrogen peroxide and Ringer's solution. Dry conditions. Placement of a 10 Redon drain and platysma suture with 3.0 Vicryl and skin suture with 5.0 Ethilon. Due to the large tumor defect, indication for protective tracheostomy, also because no neck dissection could be performed on the corresponding side and the neck is difficult to access in the event of bleeding due to the metastases. Tracheotomy: After careful palpation of the cricoid, skin incision approx. 3 cm above the 2nd tracheal cartilage. Dissect with a scalpel and scissors up to the infrahyal muscles and push the muscles aside. Further dissection up to the thyroid gland, undermining of the thyroid gland, coagulation of the thyroid gland and transection. Now blunt exposure of the trachea with the swab and visor flap incision between the 2nd and 3rd tracheal cartilage. Sutures to the skin, 4 cranial and 4 caudal to the tracheostoma. Now hemostasis by means of focal bipolarization. No bleeding at the end of the operation. Conclusion: cT2 cN2b oropharyngeal carcinoma. Please repeat neck dissection of the left side on two occasions in approx. 3 weeks. Then presentation at the tumor conference with complete TNM classification. Postoperatively, if possible, inclusion of the patient in the <STUDY_NAME> study (mention at the tumor conference).