Dictation <CLINICIAN_NAME>: Induction of anesthesia and intubation using a laser tube via the anesthesia. Entry with the Kleinsasser tube and inspection of the site. A flat exophytic mass is seen in the area of the vallecula with transition to the base of the tongue and the lingual surface of the epiglottis. Now insertion of the spreading laryngoscope and advance of the microscope including laser. Start with laser resection 4 watt continuous wave superpulse on the left side in the area of the base of the tongue. Then successive laser resection in the area of the base of the tongue down to the hyoid bone. Removal of the epiglottis in the lateral area on both sides. The epiglottis itself cannot be retained due to the tumor infiltration. The resection of the epiglottis was discussed in advance with <CLINICIAN_NAME>, who also demonstrated the findings. The specimen is placed on cork for final histology. Then several marginal samples are taken. The marginal samples are all tumor-free in the frozen section. The decision is then made to perform a tracheostomy for functional reasons, as aspiration is to be expected. The tracheostomy was performed by <CLINICIAN_NAME>. Hemostasis was performed using monopolar coagulation and vascular clips. Dictation <CLINICIAN_NAME>: Now creation of a protective tracheostomy. Head reclination. Infiltration with local anesthetic Ultracaine 2% with Suprarenin added under the palpable cricoid cartilage with a total of 10 ml. Skin disinfection and sterile draping. Mark the landmarks and the level of the cricoid cartilage. One transverse finger below, mark the skin incision according to Kocher and cut through the skin and subcutaneous tissue. Dissect down to the linea alba and enter it. Separation of the infrahyoid musculature and exposure of the small, sparse thyroid gland. Overall, hardened and fibrotic conditions after radiotherapy. Undermining of the thyroid gland and placement of the Pean clamps on the right and left. Cutting of the thyroid isthmus. Stitching of the thyroid gland on the right and left, after placement of the blocker and good view of the anterior tracheal surface. Prior to this, the cricoid cartilage was dissected, which was easily palpable. The trachea was then opened between the second and third tracheal cartilage clasps and then epithelialized, after undermining the skin to create a tension-free mucocutaneous anastomosis as a visor tracheotomy. A total of four sutures caudally and four sutures cranially. Problem-free reintubation to a 9 mm tracheostomy tube.