Preoperative loupe laryngoscopy showed regular vocal fold mobility on the left side. After anesthesia and intubation with the laser tube through the anesthesia, the first step was microlaryngoscopy: Here, the tumor described above was seen, partly exophytic, partly exulcerated, affecting the entire vocal fold and growing into the morgue sinus. Palpatorily quite coarse and growing into the anterior commissure, also a clearly subglottic growth of approx. 1 cm caudally. The upper part of the pocket folds is certainly well free, the arytenoid cartilage of the left side is also free. The left vocal fold does not appear to be affected. Therefore, after consultation with <CLINICIAN_NAME>, a laser resection will now be attempted. The tumor is first reduced in size in its anterior region. However, it turned out that it was not possible to create a good overview in the anterior commissure area and that there was significant subglottic growth in this area, which also justified the classification cT2 in any case. Therefore, after consulting <CLINICIAN_NAME> again, the decision was made to perform a partial laryngectomy from the outside. Now procedure for partial laryngeal resection via thyrotomy: Zigzag incision. Dissection through the subcutaneous tissue and platysma. Exposure of the prelaryngeal musculature. First spread the omohyoid muscle. Then identify the anterior edge of the thyroid cartilage. Two lymph nodes up to 1 cm in size are now identified in the area between the thyroid cartilage and the cricoid cartilage, which correspond to the Delphi lymph nodes. These are now resected in the sense of a selective level VI lymph node resection and sent separately for final histology. After exposing the perichondrium of the cartilage, the perichondrium is now slit paramedially on the right and then pushed to the left side with the Freer, and the thyroid cartilage is split with the wheel in the sense of a thyreotomy. Now open the inside of the larynx in the superior region. The right paramedian incision is also made at the glottic level. Now spread open the larynx with the retractor. An approx. 2 cm large tumor is revealed, which is now resected under direct vision. The inner side of the perichondrium is also removed in depth with the freer, the incision is extended caudally at the level of the cricoid cartilage and a large part of the pocket fold is resected cranially. Posteriorly, the resection includes the vocalis process of the arytenoid cartilage. The vocalis muscle on the left side is of course completely resected. Now turn to the right side. Here there is slightly irregular tissue in the most anterior area of the right vocal fold, which is why a very circumscribed resection is performed here. Now 4 quick incisions are made, once inferior and superior, once in the arytenoid area and then in the area of the right vocal fold, all of which are later found to be tumor-free. Now most careful hemostasis with bipolar coagulation and even after increasing the blood pressure to 145/90 there is no bleeding. Together with <CLINICIAN_NAME>, a tracheostomy is now dispensed with. The Keel is now inserted after making 4 small drill holes with the Lindemann burr. Then readaptation of the cranial and caudal gaps of the keel using the perichondrium and connective tissue. Readaptation of the musculature, creation of a flap and two-layer wound closure. Intraoperative administration of 250 mg SDH and 600 mg Sobelin. Patient should be presented at the tumor conference and in any case undergo a control microlaryngoscopy with Keel removal in 8 weeks.