Initially started by <CLINICIAN_NAME>. Patient identification, consultation with anesthesia colleagues. Carrying out the team time-out. Induction of anesthesia and intubation by anesthesia colleagues. Tracheobronchoscopy is not possible here if intubation conditions are difficult. Now intubation with the small bore tube. No suspicious mass in the oral cavity, oropharynx, base of tongue, vallecula, epiglottis, aryepiglottic f......s and postcricoid area. The mass/tumor grows from the pocket fold on the left, completely infiltrating the vocal fold and extending over the anterior commissure to the vocal fold on the right, growing circularly on the left and extending 2 cm to the subglottic area. Skin disinfection of the surgical area. Infiltration anesthesia in the area of the apron flap. Repeated skin disinfection of the surgical area and sterile draping of the surgical area. Now mark the landmarks, jugulum, mastoid, chin, sternocleidomastoid anterior border, jaw angle and mandibular branch on both sides and mark the apron flap up to approximately 2 to 3 cm cranial to the jugulum. Make the skin incision using an electric needle through <CLINICIAN_NAME>. Subsequently, further preparation of the neck dissection by <CLINICIAN_NAME>. First cut through the platysma and develop the apron flap subplatysmal to cranial. This is fixed with holding sutures. Then expose the anterior margin of the sternocleidomastoid and dissect along it. Exposure of the omohyoid and exposure of the right mandibular salivary gland. Exposure of the digaster venter muscle anteriorly and posteriorly. Visualization of the auricularis magnus. Exposure of the accessorius nerve and protection of the same. Demonstration of findings to <CLINICIAN_NAME>. He recommends dissecting only level II from the jugular vein medially and an identical procedure on the opposite side. This is carried out. Exposure of the hypoglossal nerve, the jugular vein and the facial vein. All structures are spared. An enlarged lymph node is located in the jugulofacial angle, which does not appear to be primarily suspicious. This neck specimen is sent for final histology. Now identical procedure on the opposite side. The external jugular vein is exposed and spared. The anterior border of the sternocleidomastoid, the omohyoid and the posterior and anterior digaster venter muscles and the mandibular salivary gland as well as the hypoglossus and the accessorius are also exposed and spared. The neck preparation is also dissected medially from the jugular vein and cranially from the bifurcation to the medial side. A lymph node is also enlarged here, but not suspicious. The facial vein and internal jugular vein are also exposed and spared here. Now expose the omohyoid muscle and skeletonize it. The tumor is now resected: the hyoid bone is exposed and the infrahyoid muscles are dissected on both sides, detached from the larynx and folded laterally and caudally. Detachment of the supraglottic soft tissues up to the pharyngeal wall. The soft tissues go with the larynx to the specimen. Expose the thyroid isthmus and cut it. Dissect the thyroid gland together with the overlying infrahyoid musculature caudolaterally from the laryngeal skeleton. This is done in the same way on both sides. Individual branches of the superior thyroid artery are supplied or ligated bipolarly, the artery remains intact on both sides. Exposure of the trachea on the upper 4 to 5 cm. The trachea is now opened in the 2nd/3rd intercartilaginous space with epithelialization of the caudal part. No tumor here. Then expose the cornu superius on both sides and detach the pharyngeal muscles or the constrictor pharyngis on both sides. Push off the piriform sinus on both sides. Subsequent entry into the pharyngeal space at the level of the epiglottis. Exposure of the tumor. Successive development of the larynx. Detachment below the postcricoid region from the esophageal tube. Subsequent separation of the larynx from the trachea, which remains slightly elongated dorsally towards the cranium. Larynx is suture-marked for frozen section. In the frozen section, the tumor is relatively close dorsally in the area of the cricoid cartilage, no tumor infestation in the area of the trachea, here the clearly subglottically growing carcinoma is tumor-free or removed in healthy tissue. Resection of soft tissue on the esophageal tube from paramedian right to left is now performed again. A portion of the caudal hypopharynx in the area of the postcricoid mucosa is also removed again. Both specimens are sent for frozen section. No more tumor infiltrates here, so the tumor is finally removed from the healthy tissue. The myotomy is now performed in the typical manner on the left. Significantly improved by passage of the finger. Muscle bundles are cut through to the mucosa. Subsequent insertion of an 8 mm Provox prosthesis in the typical manner without problems. Good fit. Then 1st inverting suture with 4.0 Vicryl single button sutures inverting. A 2nd inverting suture of the musculature is performed over the 1st suture, also in single button sutures with Vicryl 3.0. Then a 3rd suture with adaptation of the constrictor pharyngis musculature, suprahyoidal constrictor pharyngis muscle is also adapted to the supraglottic musculature. The thyroid gland is adapted caudally over the suture area. Subsequent careful irrigation and hemostasis of the entire area. Wound closure in layers without insertion of a Redon drain in each side of the neck and epithelialization of the tracheostoma. Finally, insertion of a 10 mm tracheostomy tube. The procedure was completed without complications. Overall cT3 to 4 transglottic carcinoma on the left side, no clear clinical lymph node involvement observed. Further procedure after receipt of the final histology. Presentation at the interdisciplinary tumor conference. Postoperatively, the patient is ventilated and admitted to the intensive care unit. Nutrition here via the inserted gastric tube for 10 days, then gruel swallowing and, if necessary, diet build-up. Please continue antibiotics, which were started intraoperatively with Unacid, for 1 week.