First induction of anesthesia and intubation by the anesthetist. Position the patient and enter with the flexible esophagoscope and inspect the esophagus and stomach. No abnormalities here. Perform panendoscopy with the small bore tube. A conspicuous area of mucosa can be seen on the upper edge of the epiglottis on the right side and also in the vallecula on the left side. These are biopsied and sent for frozen section. Mild to moderate dysplasia is found on both sides. Insertion of the spandex and looping of the tongue. Inspection of the tumor region: There is an exophytic mass at the glossoalveolar fold with transition to the base of the tongue and the soft palate. Incision of the mucosa with the monopolar needle. Start with resection in the area of the soft palate. The back surface of the soft palate with mucosa can still be preserved here. The tumor grows very extensively at this point. Further tumor resection in the area of the posterior pharyngeal wall, the posterior palatal arch and the base of the tongue. The tumor can be easily lifted away from the alveolar ridge so that there is no exposed bone. The entire tumor specimen is thread-marked for frozen section. A carcinoma in situ can only be seen in the area of the posterior pharyngeal wall, transition to the base of the tongue. A resection is taken here and another marginal sample is taken. Overall complete R0 resection. In the area of the pharyngeal side wall, some cervical fatty tissue is visible at one point. TachoSil is applied here and the pharyngeal muscles are sutured over to prevent a fistula from forming. Due to the large wound area and poor intubation of the patient, the decision was made to perform a tracheostomy. Skin incision below the cricoid cartilage. Dissection down to the musculature. Splitting of the muscles in the midline. Exposure of the thyroid gland. Dissection of the thyroid isthmus. Exposure of the anterior wall of the trachea. Entering the trachea between the 1st and 2nd tracheal cartilage. Creation of a visor tracheotomy. Suturing of the skin to the anterior wall of the trachea and insertion of an 8-gauge tracheal cannula. At the end, insertion of a nasogastric tube. Continuation of antibiotics with Unacid for three days. Feeding via the nasogastric tube for three days, then carefully build up the diet.