Primary tumor resection:
The tumor and an area of surrounding tissue that appears normal are removed in this operation. Removing some normal tissue decreases the likelihood that small deposits of cancer will be left behind in the surgical wound. The tumor can be removed through the mouth or, with larger tumors in the pharynx, through an incision in the neck. A mandibulotomy, an operation in which the jawbone is split with a saw to access the tumor, may also be performed.

Full or partial mandible resection:
A primary tumor resection without removing any bone tissue is recommended if there is no evidence that the cancer has grown into the jawbone. If the tumor has entered the jawbone but there is no evidence of further spread into the bone on X-ray, then a partial portion of the mandible is removed. If there is evidence of jawbone destruction on an X-ray, the entire jawbone may be removed.

Maxillectomy:
A maxillectomy or partial maxillectomy involves removing part or all of the hard palate, the bony roof of the mouth (or floor of the maxillary sinus). Prostheses can be used to fill defects resulting from these operations.

Mohs' micrographic surgery:
Some cancers that involve the lip and other structures may be removed by Mohs' surgery, also known as micrographic surgery. The surgeon removes the tumor in thin slices and immediately examines each slice under the microscope for cancer cells. Additional slices are taken out until the cancer is completely removed. This method can minimize the amount of normal tissue removed along with the tumor and help preserve normal structures.

Neck dissection:
Cancers of the oral cavity and oropharynx often spread to lymph nodes in the neck. Depending on the stage and location of the cancer, it may be necessary to remove these lymph nodes by a neck dissection. The amount of tissue removed depends on the size of the primary cancer and the extent to which it has spread to lymph nodes. A partial or selective neck dissection removes only a few lymph nodes, a modified radical neck dissection removes nerve tissue and a radical neck dissection removes nearly all nodes on one side as well as more nerves, muscles and veins.

Pedicle or free-flap reconstruction:
While the area of normal tissue removed along with small tumors usually does not require reconstruction, surgery may be needed to repair defects in the mouth, throat or neck caused by removal of larger tumors. Sometimes a split-thickness skin graft, in which a thin slice of skin is taken from the thigh, can repair a small defect. To repair a larger defect, a piece of muscle with or without skin may be rotated from a nearby area, such as the chest (pectoral pedicle flap) or the upper part of the back (trapezius pedicle flap). Tissue from distant areas of the body such as the intestine, arm muscle or skin, abdominal muscle or lower leg bone may also be used to replace parts of the mouth, throat or jawbone.

Tracheostomy:
If an oral or oropharyngeal cancer is blocking the throat and is too large to remove completely, a hole may be made in the neck (tracheostomy) to bypass the tumor and allow the patient to breathe more comfortably. It may be used as a temporary measure after major head and neck surgery.