After active patient identification, the patient is brought into the operating theater. Carrying out the team time-out. Introductory consultation with the anesthesia colleagues. Induction of anesthesia and intubation of the patient. Positioning of the patient by the surgeon. Insertion of the mouthguard. Insertion of the size D Kleinsasser tube. First, adjustment of the endolarynx. A scar is visible in the area of the left anterior third of the vocal fold. The anterior commissure is extremely difficult to adjust. Using the O° view, a slightly uneven area of mucosa can be seen in the area of the anterior vocal fold with a transition to the anterior commissure. Endolaryngeal laser resection does not appear to be a sensible option. Therefore, as discussed with the patient in advance, remove the Kleinsasser tube and proceed to chordectomy via a thyrofissure. First reposition the patient. Skin spray disinfection and infiltration anesthesia. Abjoration of the surgical site and sterile draping. Clear identification of the thyroid incissure and the level of the cricoid cartilage. Marking of the planned incision using the broken line technique. Sharp cutting of the cutis as well as the subcutis. Insertion of the sharp retractor. Exposure of the prelaryngeal musculature. Separation of the same in the area of the linea alba. Exposure of the thyroid cartilage. Incision of the perichondrium in the median line and formation of 2 perichondrium lobes. Horizontal incision in the area of the ligamentum conicum. Open the thyroid cartilage strictly in the median line using the wheel. Insertion of the 2-pronged retractor and meticulous inspection of the endolaryngeal findings. This shows the previously detected endoscopically unstable mucosal area in the area of the left anterior third of the vocal fold with transition to the anterior commissure. The 15 mm scalpel is now used to make a circular incision around the mass with an appropriate safety margin. Part of the perichondrium in the area of the anterior commissure is also resected. The specimen is thread-marked and sent for definitive histological processing. In addition, 4 marginal samples are taken (upper left vocal fold, lower left vocal fold, anterior commissure and right anterior commissure). All frozen sections were found to be tumor-free intraoperatively. There was also no evidence of CIS. Since all marginal specimens show the tumor area in a circular fashion, an R0 resection can be assumed. Grinding of the inner cortex in the area of the former left anterior third of the vocal fold. The remaining thyroarytaenoid muscle is preserved. Wound irrigation with H202 and Ringer's solution. Creation of a total of 4 drill holes. Closure of the laryngeal skeleton with PDS 4.0. Closure of the incision in the area of the ligamentum conicum. Suturing of the previously prepared perichondrium leaves. Readaptation of the prelaryngeal musculature. A second layer of prelaryngeal musculature is also stitched laterally over the median line to create a corresponding counterpressure. Finally, insertion of a flap, subcutaneous suture with Vicryl 4-0 and skin suture with Ethilon 5-0. Application of a wound dressing and completion of the operation without complications. Conclusion: This resulted in a chordectomy via a thyrofissure. Intraoperative R0. Preoperative computed tomography findings also cT1c N0. Due to the preoperative sonographic findings in the neck, please monitor closely and present the patient to the tumor conference as standard. With regard to the cerebellar mass, please undergo further magnetic resonance imaging during the inpatient stay.