Initial laryngoscopic adjustment of the glottic plane after an initial consultation with the anesthesia colleagues and intubation anesthesia. A tumor of the anterior commissure is seen here, which is mainly located in the anterior third of the left vocal fold and then reaches the right vocal fold via the anterior commissure and also appears to infiltrate it. The patient is extremely difficult to adjust, which is why an external resection is indicated due to the tumor location and adjustability. The patient is therefore first repositioned and local anesthetic with adrenaline is injected. Then a zigzag-shaped prelaryngeal incision is made. Layered preparation in depth. Ligation of larger veins. Then exposure of the laryngeal skeleton. Exposure of the cricoid cartilage and exposure of the ligamentum conicum. Transverse incision of the ligamentum conicum and subsequent execution of the thyrofissure. This is performed in the midline. Then open the endolarynx in the anterior commissure. The tumor described above can be seen on the left side and in the anterior part of the right side. The tumor is then undermined at the base of the thyroid cartilage and initially detached. The tumor is then resected tangentially with a sufficient safety margin on the left side. The specimen is suture-marked with the caudal, dorsal and cranial suture markings for the frozen section. These resection margins are all found to be tumor-free in the frozen section. Then take a marginal sample from the anterior commissure at the caudal deposition area. This is also tumor-free in the frozen section. Then move to the right side and also undermine the tumor on the perichondrium. Here too, tangential resection of the tumor with a sufficient safety margin. In the dorsal settling area, take a marginal sample, which is also assessed as tumor-free in the frozen section. Then fixation of the vocal fold on the right side at the anterior commissure, which had been detached here. To do this, two mattress sutures were placed on the anterior edge of the thyroid cartilage in the area of the thyrofissure line. Then adaptation of the resection margins in the area of the separation on the left vocal fold. Here too, mobilization of the soft tissue and suturing anteriorly to the thyrofissure margin. Then measure a laryngeal larynx. This is then inserted in a size of 14 mm and the thyroid cartilage is adapted. Then suture the ligamentum conicum. Suture of the prelaryngeal musculature. Subsequent two-layer wound closure after insertion of a wound flap and application of a pressure bandage. Final discussion with the anesthesia colleagues. Due to the location and adjustability, this tumor of the anterior commissure as well as the left vocal fold and the anterior part of the right vocal fold had to be resected from the outside. Based on the representative marginal samples, the specimen shows an R0 resection. Further procedure depending on the decision of the interdisciplinary tumor conference