Induction and intubation by the anesthetist. Inspection of the oral cavity. Insertion of the spandex and looping of the tongue. Mobilization of the tongue. There is an exophytic mass on the edge of the tongue on the right side with transition to the base of the tongue and the floor of the mouth with extensions into the anterior floor of the mouth. Mark the edges of the incision with the monopolar needle with a safety margin of 0.5 to 1 cm. The mass is then dissected out all around with scissors and bipolar forceps. It is sent to histology marked with a thread. The pathologist can only detect a very narrow resection margin in two places: the lateral floor of the mouth and the basal floor of the mouth. Both are resected again and another marginal sample is sent for frozen section, so that the tumor is ultimately resected with an R0 situation. The result is a fairly large defect that affects the edge of the tongue and also the floor of the mouth. An extracapsular dissection of an unclear mass on the right parotid gland was then performed. This is also sent for a frozen section. Here the pathologist can identify a Warthin's tumor. Neck dissection performed on the left side by <CLINICIAN_NAME>. Here the platysma is shown. Dissection of the platysma. Dissection of the platysma. Exposure of the sternocleidomastoid muscle, the internal jugular vein, the accessorius nerve and the digastric muscle, the submandibular gland. Clearing of levels I to IV while sparing the plexus branches and the submandibular gland and hypoglossal nerve. Neck dissection on the right side. Exposure of the platysma. Dissection of the platysma. Exposure of the sternocleidomastoid muscle, the submandibular gland, the digastric muscle, the accessorius nerve, the internal jugular vein, vagus and external/internal carotid artery. Removal of the submandibular gland. Release of the neck preparations I to V while protecting the plexus branches. Blunt dissection towards the floor of the mouth and creation of an opening to the oral cavity. The opening is wide enough to allow 4 transverse fingers to pass through, so the digastric muscle is not cut. The defect is covered with a supraclavicular island flap. Before starting the operation, the transverse cervical artery was identified and marked using the hand-held Doppler. Skin incision over the acromion into the shoulder area. Cutting around the flap, 8 x 5 cm. Lift the flap, taking the fascia of the deltoid muscle with it. Dissection of the pedicle without exposing it, taking subcutaneous fatty tissue with it. Creation of a bridge to the neck. Pulling the pedicle and flap through the bridge and inserting the flap into the mouth area. Incision of the flap in the tongue and floor of the mouth area. Due to the Warthin's tumor in the parotid gland, which also shows other masses, a complete parotidectomy is performed after consultation with <CLINICIAN_NAME>. For this purpose, a facial nerve monitor is placed. Visualization of the main trunk of the facial nerve. Exposure of the first major division. Then dissection along the branches and removal of the entire parotid gland tissue. Then removal of the glandular tissue below the main trunk and between the branches. Finally, insertion of Redon drains and two-layer wound closure. Finally, creation of a tracheostoma. For this, skin incision in the usual manner. Dissection down to the thyroid gland. Dissection of the thyroid gland. Exposure of the trachea. Creation of a visor tracheostomy. Creation of a mucocutaneous anastomosis and insertion of an 8-gauge tracheostomy tube. The patient goes to the intensive care unit.  