The management of advanced carcinoma of the head and neck excluding thyroid carcinoma requires a combination of operation and radiation therapy to give the patient the best chance of cure. It is not appropriate to try to extirpate advanced squamous cell carcinoma by operation alone. There is evidence that postoperative radiation therapy is more effective in local regional control at least in certain sites than preoperative radiation therapy and there is better patient acceptance of the treatment plan in which the radiation therapy is administered after the operation.