There is a head and neck surgeon at NYU by the name of Marc DeLacure. I have seen a couple cases he did with tumors that were wrapped around carotids that no one else would touch. Needless to say this is not for the fainthearted. Even with lots of experience,these surgeries are very individual given the situation, and one size does not fit all as they say. But Mark is at the top of his game, I personally have trusted my life to him on the table for a sinus surgery that no one else would touch as there was a high chance that I could be blind at the end of it. ( I'm not) I know you are already at one of the best institutions in the whole world, Randy Webber there who is the head of the department has a stellar rep as a cutter. But not everyone will take on this kind of high risk thing. If after considering all this, and you want me to introduce you to someone else to look at the scans, I would be pleased to do so, no promises about what they will say. But as has been stated, not every surgeon has the skill sets, nor the desire to do this kind of case, and not every case is actually doable. Chemo is likely not going to do much in the long view through it may slow things down. Immunotherapies in head and neck are not even in the clinical trial stage right now; I sit on the National Cancer Institute oversight committee, on H&N immunotherapy, and we are still talking about the appropriate approach to the trials themselves. Options are few, and MDACC knows what those are. I would put a lot of weight on their combined opinions as to what is possible and what direction you should go in. They saved my life the first time when my chances of making it were stated to me to be about 12%�. by MDACC. No chance at all was said by others by others who will go unnamed. I trust those MDACC people in spades.