Introductory consultation with the anesthesia department to release the patient. Induction of anesthesia. Performance of tracheoscopy: inconspicuous conditions in the endolarynx up to the bifurcation. Careful inspection of the larynx with microlaryngoendoscopy as well as the hypopharynx and base of the tongue: An ulcerated area is then found here. This is biopsied and found to be a carcinoma in situ invasive carcinoma in a frozen section. Therefore, complete performance of the above-mentioned procedure. To do this, first position the tumor with the spreading laryngoscope, then cut around the tumor with the 8 W CO2 laser. The tumor can be sent as a complete specimen for histology. Positive marginal samples with a CIS in the middle of the tongue base and caudal or caudal right. For this reason, at the end of the operation, a resection is taken from the middle of the base of the tongue and a marginal sample is taken. The same is done on the caudal right section. A resection with a final marginal sample is also taken here. Additional resection in the area of the wound base, as the tumor is relatively close to the edges of the wound according to the frozen section. If the mucosal margins in these areas are completely inconspicuous on inspection, these samples are sent for final histology. The tumor at the base of the tongue is generally difficult to control, which is why surgical conditions are also difficult here. In the meantime, radical neck dissection is performed on the right side: skin incision for this. Subcutaneous dissection in depth. Exposure of the sternocleidomastoid muscle. The mass infiltrating the muscle and the accessorius nerve can already be seen here. The digastric muscle is first exposed cranially. The internal jugular vein is shown caudally. This shows that it is probably infiltrated by this tumor, so that the decision is made to sacrifice the internal jugular vein. It is exposed caudally and cranially, ligated and sent for histology together with the radical neck preparation, taking the sternocleidomastoid muscle with it, after resection. Exposure of the accessory nerve and the external and internal carotid arteries. Exposure of the hypoglossal nerve and protection of the same. Displacement, neurolysis and re-embedding of the accessory and hypoglossal nerves. Development of the lateral neck preparation, as already described up to just below the omohyoid muscle. Development of the medial neck preparation, including the capsule of the submandibular gland in the caudal part. Overall, due to the extensive and large metastasis, the surgical conditions were considerably more difficult. Careful wound irrigation in the area of the neck preparation. Insertion of a Redon drain. Multi-layer wound closure. Skin suturing with Monocryl sutures. Application of a pressure bandage. Final inspection at the end, no bleeding. Final consultation with the anesthetist. Completion of the procedure. Note: Diagnosis: cT2 cN3 oropharyngeal carcinoma on the right.