Nasopharyngeal carcinoma (nasopharyngeal carcinoma) is a tumor that occurs in the mucosa of the nasopharynx. It is the most common malignant tumor of the head and neck, and its treatment is based on radiotherapy and chemotherapy, mostly without surgical intervention. In this case, the patient had undergone radiotherapy several times in 3 years, and the lymph nodes in the neck recurred, ruptured, smelled bad and invaded important blood vessels and nerves in the deep side of the neck. Our department performed salvage surgical treatment for the patient’s condition at the same time, and the operation was successful with the first-stage repair and reconstruction of autologous flap.