Initially induction of anesthesia and transoral endotracheal intubation by the anesthesia colleagues and positioning of the patient by the surgeon. Pharyngo- and laryngoscopy are performed. The piriform sinuses on both sides, the posterior wall of the hypopharynx and the postcricoid region were unremarkable. In the area of the endolarynx, an exophytic mass was found, partially growing in the area of the left glottis and subglottically, extending approx. 10-15 mm below the glottic level. Subsequently, a flexible endoscopy of the esophagus and stomach was performed, where the findings were unremarkable. Good diaphanoscopy. Skin spray disinfection, application of local anesthetic abdominally, skin ablation and sterile draping. Problem-free insertion of a PEG tube using the thread pull-through method in the typical manner. Subsequent repositioning of the patient. Skin spray disinfection, application of local anesthesia cervically on both sides and medially, skin ablation and sterile draping. First skin incision. Cut through the subcutaneous tissue and the platysma. Formation of a subplatysmal flap up to the level above the hyoid bone. Exposure and ligation of the external jugular vein on both sides. Continuation of the right skin incision into the infraauricular region for the planned right parotid surgery. Exposure of the anterior border of the sternocleidomastoid muscle. Exposure of the omohyoid muscle. Exposure of the accessorius nerve. Exposure of the capsule of the submandibular gland, the posterior venter of the digastric muscle and the hypoglossal nerve. Exposure of the cervical vascular sheath from caudal to cranial up to the level of the posterior venter of the digaster muscle. Successive evacuation of region I b, II, III, IV and V on the right side. Several conspicuous nodules were found in region II, III on the right. Hemostasis there by means of bipolar coagulation. Subsequent exposure of the anterior border of the sternocleidomastoid muscle on the left side. Exposure of the omohyoid muscle, exposure of the posterior venter of the digaster muscle. Exposure of the capsule of the submandibular gland on the left side. Exposure of the accessorius nerve. Exposure of the cervical vascular sheath from caudal to cranial. Successive evacuation of region I b, II, III, IV and V on the left side. There are several highly visible nodes in region II, III on the left. Caudal removal of the specimen after treatment of the caudal margin by means of repositioning to avoid a chyle fistula and subsequent skeletonization of the hyoid bone. Deposition of the prelaryngeal musculature on the hyoid bone. Skeletonization of the thyroid cartilage, the cricoid cartilage and the anterior wall of the trachea after transection of the thyroid isthmus. Creation of a tracheal incision between the 3rd and 4th tracheal cartilage clasp. Re-intubation of the patient onto a size 8 laryngectomy tube, followed by skeletonization of the posterior edge of the thyroid cartilage on both sides. Preservation of the wall of the piriform sinus on both sides. Cranial exposure of the epiglottis and its free edge. Median pharyngotomy. Incision along the aryepiglottic folds on both sides. Transverse incision postcricoid. Union of all incisions. Entering the layer between the postcricoid region and the posterior wall of the cricoid cartilage. Expose the ramus between the trachea and esophagus and place the specimen at the level of the already created tracheostoma. The specimen is sent in for intraoperative frozen section examination marked with a suture (tracheal sedimentation margin), and the following 5 marginal specimens are also sent in for intraoperative frozen section examination: postcricoid, hypopharynx right, hypopharynx left, base of tongue right, base of tongue left. All marginal samples are found to be tumor-free by the pathology colleagues. Subsequently, cricopharyngeal myotomy is performed on the left paramedian in a typical manner. Insertion of a size 8 Provox prosthesis in the typical manner. Subsequent pharyngeal suture over 3 layers (mucosa, submucosa, muscular layer). The T-shaped pharyngeal suture is reinforced using Tachosil pieces cut to size. The prelaryngeal musculature is then readapted into the midline. Continuation of the right cervical skin incision into the infraauricular region. Exposure of the capsule of the parotid gland. Formation of a small flap (skin, subcutaneous tissue, SMAS) anteriorly. Subsequently entering the parotid parenchyma under electromyographic control and performing a bifocal extracapsular dissection of 2 masses in the caudal parotid capsule. Hemostasis there by means of bipolar coagulation. No facial branch is shown. Primary closure of the parotid capsule. Subsequent completion of the epithelialization of the tracheostoma. Two-layer wound closure of the entire apron flap. Placement of 2 10-gauge drains. Re-intubation of the patient to a size 10 cannula. Dressing applied. Completion of the procedure without complications. The patient received intraoperative single antibiotic Unacid 3 g intravenously. Please request suture removal on the 8th postoperative day and X-ray gruel swallow on the 10th postoperative day.