First induction of anesthesia by anesthesia, then entering with the 0° optics and inspection of the trachea. This can be seen freely up to the carina and is non-irritating. Then intubation by the surgeon with Cormack I. The flexible esophagoscope is then inserted and the esophagus is visualized through to the stomach, where the mucosa is free of irritation on all sides. Retract the esophagoscope and enter with the small bore tube. Inspection of the oropharynx. This shows the previously described mass at the upper left tonsil pole. Mirroring forward to the posterior pharyngeal wall and hypopharynx. Inconspicuous on all sides. Inspection of the piriform sinus and the entrance to the esophagus as well as the postcricoid region and the arytenoid region. No tumorous masses. Adjustment of the glottic plane and inspection of the vocal folds and pocket folds including the anterior commissure. No abnormalities here. Insertion of the tonsil stop and inspection of the left tonsil lobe. A rough mass can be seen at the upper tonsil pole with transition to the anterior palatal arch. The mucosa is incised with a safety margin using the monopolar needle. Then further preparation with scissors and bipolar forceps. Removal of the tonsil including the mass with a safety margin. The tonsil is thread-marked for histology. Then removal of marginal samples, thread-marked. 1st marginal sample anterior palatal arch, suture marking near the uvula, 2nd marginal sample oropharyngeal side wall, suture marking base of tongue, 3rd marginal sample base of tongue, without suture marking, 4th marginal sample posterior palatal arch, also suture marking base of tongue. Then inspection of the alveolar ridges. A suspicious change in the mucosa in region III/VII to VIII can be seen on the alveolar ridge on the lower jaw. This is biopsied. Then inspection of the alveolar ridge on the left side of the maxilla. There is actually no suspicious mass here, but as a contrast agent uptake was described in regions II/IV to II/VI on the CT, this region was also biopsied. Hemostasis by insertion of hydrogen swabs and bipolar coagulation. The operation was completed with dry blood, without complications. Conclusion: cT1 cN0 tonsillar carcinoma on the left. Neck dissection on the left side should be planned, if necessary with resection if the marginal samples are not healthy. If the samples from the alveolar ridges also show carcinoma or carcinoma in situ, the patient should be presented to the maxillofacial clinic.