Study Surgery:

      If you are found to be eligible to take part in this study, you will be scheduled for
      surgery. You will receive general anesthesia to make you sleep during the procedure. You will
      be asked to sign a separate consent form that describes the anesthesia and its risks. If the
      doctor thinks it is needed, the abnormal area will be looked at with a tube that has a
      lighted camera on one end (called a laryngoscopy) to check the size of the tumor and to look
      for any additional cancerous areas.

      The tumor will be exposed with standard equipment after the teeth are protected with a dental
      guard. Using the robotic surgical system, the tumor will be removed.

      Your affected lymph nodes will be surgically removed through your neck. The robotic system
      will not be used for that part of the surgery. The nerve that controls the shoulder, the
      blood vessel that brings blood back to the heart from the brain and neck, and the major
      muscle of the front of the neck will all be saved, unless the tumor in the lymph nodes has
      grown directly into those areas. A drain will be placed before the surgical wound is closed.
      The drain will usually be removed within a week after surgery.

      Based on the results of surgery, you will receive adjuvant therapy (therapy after the
      surgery). For example, if your surgery does not remove enough of the cancer, you will be
      referred to receive radiation therapy. There will likely need to be a 1-2 week delay before
      you can receive radiation therapy. Your doctor will discuss this therapy with you in more
      detail, including the risks.

      Length of Study:

      The surgery will be stopped if the doctor thinks the tumor is too large to be removed with
      the robotic system. You will be taken off study if you are unable to follow study directions.

      Your participation on the study will be over after the follow-up visits and data collection.

      Follow-Up Visits:

      Within 1-4 weeks after surgery (+/- 3 days):

        -  You will have a physical exam, including a cranial nerve exam of your tongue, palate,
           and facial nerves.

        -  You will have an MBS.

        -  You will meet with a speech pathologist.

        -  You will complete the questionnaires about your speech and swallowing function.

      At 6 months (+/- 2 months), 12 months (+/- 2 months), and 24 months (+/- 6 months) after
      surgery:

        -  You will have an MBS.

        -  You will have a cranial nerve exam of your tongue, palate, and facial nerves.

        -  You will meet with a speech pathologist.

        -  You will complete the questionnaires about your speech and swallowing function.

      As often as the doctor thinks it is needed for up to 5 years after surgery, the study staff
      will check your medical record to find out how you are doing and about any treatments and
      follow-up you have had.

      This is an investigational study. The robotic surgical procedure (the daVinci Surgical
      System) is FDA approved and commercially available. The study doctor can explain how the
      surgery is designed to work.

      Up to 150 participants will be enrolled in this study. All will be enrolled at MD Anderson.