Hello @anonymous624. I also have metastatic SCC from skin origin, though mine was in my ear. Skin origin are never HPV associated per my Mayo Oncologist. My initial surgery included a temporal bone resection and select neck dissection with superficial parotid removal. My facial nerve was involved in the tumor so it was transected and the affected portion removed and reattached. The facial paralysis was total on that side as the nerve grew back together, then there is a fun thing called synkinesis where new nerves control different parts of the face. For example trying to smile on the affected side might raise your eyebrow a bit also.
It is a challenge but better than cancer.
But hopefully the Libtayo will shrink your tumor so no worries about facial nerve damage. Libtayo totally cleared my last kidney metastasis and I understand that it works better on skin origin SCC than mucous membrane origin inside the oral cavity. I had two surgeons at Mayo Clinic Rochester and both were ENT specialists, and the one who did the neck was also a plastic surgeon. Cancer surgeries of the head and neck is pretty much all he does. I would choose an oncological surgeon over plastics unless he/she specialized in cancer surgeries. You want a surgeon who does this type of surgery regularly, not occasionally. That is the benefit of a large referral center or cancer center where the doctors are quite specialized. Are you dealing with local doctors or do you have a referral center close by?