At the beginning of the operation, induction of intubation anesthesia by the anesthesia colleagues. Then tracheoscopy: No abnormalities in the trachea area. The mucous membranes here are smooth and unremarkable. The patient is then intubated by the anesthetist. Esophagoscopy: The flexible instrument enters the esophagus without any problems. Then visualized up to the stomach. A clearly reddened erosive mucosa in the form of erosive gastritis can be seen. The stomach is otherwise empty. The mucous membranes show no evidence of a tumor or other mass. After releasing the insufflated air, the esophageal mucosa is then reflected back and carefully inspected. No evidence of a mass or other changes to the mucosa. Hypopharyngoscopy and laryngoscopy: No mucosal abnormalities in the hypopharynx and larynx. The vallecula is free, the base of the tongue is free, there is a regular laryngeal skeleton. The piriform sinus can be freely unfolded on both sides. The postcricoid region and the esophageal entrance plane also appear normal. Then insertion of the oropharyngeal retractor and inspection of the oropharynx. In the area of the tonsillar lobe on the left side, an exophytic change in the mucosa can already be seen beginning at the anterior palatal arch, which extends into the glossotonsillar groove and to the base of the tongue. It also appears to infiltrate the edge of the tongue in the posterior third. The mucosa below the lower tonsil pole is free and inconspicuous. The other mucous membranes in the oropharyngeal region appear free and inconspicuous. The mass does not appear to infiltrate the base of the tongue. Tumor resection then begins on the anterior palatal arch. The resection margins are initially marked with the monopolar coagulation needle with a sufficient safety margin. The tumor is then successively removed from the tonsil larynx with subtotal removal of the anterior palatal arch under careful hemostasis. The lower pole of the tonsil appears relatively inconspicuous. Nevertheless, a sufficient safety margin is also maintained here in the area of the transition to the tongue base tonsil. At the transition to the glossotonsillar groove, the tumor can be seen infiltrating into the edge of the tongue as described above. Therefore, in order to have a better overview here, removal of the mouth retractor and insertion of a reinforced sharp hook to open the mouth. Then suture the tongue and pull out the tongue. The glossotonsillar groove and the edge of the tongue can thus be exposed very well. Here too, the tumor is then cut around with a sufficient safety margin and removed. The defect in the tongue is closed with inverting sutures. This is preceded by careful hemostasis. The tumor specimen is then thread-marked in toto for final histological assessment. In the resection area of the anterior tongue margin and in the area of the retromolar glossotonsillar groove as well as on the posterior and anterior palatal arch, several marginal samples are taken for frozen section and sent in. Here the intraoperative frozen section announcement is: all marginal samples are tumor-free. The patient then has a nasal feeding tube inserted via the right nostril. Due to the defect in the area of the tonsil tube and at the edge of the tongue, the patient should be fed via this tube for a week. The patient was then repositioned for neck dissection on the left side. First injection of local anesthetic with adrenaline in the area of the anterior border of the sternocleidomastoid muscle. Then ablation of the skin. Subsequent skin incision in the area of the anterior border of the sternocleidomastoid muscle. Dissection in depth in layers and exposure of the cervical vascular sheath. The omohyoid muscle is exposed in the caudal section, the digaster venter posterior muscle is exposed in the cranial section. Then locate the accessorius nerve. Then detach the lateral neck preparation. It becomes apparent that in the area of the vein angle a highly visible mass must be sharply dissected from the vein wall. However, this is achieved with difficulty, so that the internal jugular vein can be well preserved. After clearing out the accessory triangle, the complete lateral neck preparation is fully developed and removed. The hypoglossal triangle is then removed. Exposure of the hypoglossal nerve and the branches of the internal carotid artery. All structures are spared. Then develop the anterior neck preparation. In the case of extensive goiter, the superior thyroid artery must be removed here despite extreme caution. The most careful hemostasis is then performed. The specimen is then sent for final histological examination with the tumor. After rinsing the wound and checking the bleeding again, a Redon drain is inserted and the wound is closed in several layers. The procedure is then completed without complications.