First position the head. Insertion of the mouthguard. Entering with the B-tube, later with the spreading laryngoscope. Visualization of the process. This can be seen in the area of the lateral side of the arytenoid fold towards the front of the piriform sinus and extending laterally. With the spreading laryngoscope, adjustment. Then with the laser 5 watt super pulse. Remove the process with a safety margin of 0.5 to 1 cm on all sides. Smaller vessels are coagulated monopolarly. Resection reaches musculature, but only superficially. The entire process is removed and marked with sutures and then proceeded to the frozen section. No tumor infiltrates at the edges and basally, thus R0 resection. Due to the pre-irradiation up to 66 Gy and the location of the tumor next to the larynx, first insertion of a nasogastric feeding tube in the typical manner and fixation. Followed by tracheotomy. This is performed by <CLINICIAN_NAME>. Small incision in the area of the old scar. Straight dissection up to the tracheal cartilage and insertion into the trachea. Only slight opening caudally, maximum atraumatic procedure. Two sutures for epithelialization. Subsequent insertion of a 7 mm tracheal cannula without any problems. Completion of the procedure without complications after a further check of the ......., here no bleeding and removal of the swabs. Patient goes to the recovery ward postoperatively.