First tracheoscopy performed by <CLINICIAN_NAME>, no abnormalities here. Then intubation and insertion with the small bore tube. Inspection of the oropharynx. There is a whitish deposit on the left posterior palatal arch, which corresponds to the pre-biopsy carcinoma in situ site. This deposit is very superficial and extends to the medial edge of the uvula. Then inspection of the tonsil region. The tonsil on the left side is larger and bulging compared to the right side, but is unremarkable on inspection and palpation. Palpation reveals an elongated styloid process in both tonsillar lobes. Then, protrusion to the hypopharynx. No abnormalities on the right side. On the left side there is a 0.5 x 0.5 cm exophytic mass on the lateral side wall of the piriform sinus, which is biopsied, and, independently of this, a 1 x 2 cm exophytic mass on the posterior wall of the piriform sinus in the transition to the medial side wall of the piriform sinus, which is also biopsied. Esophageal entrance, postcricoid region, supraglottis and glottis with vocal fold level unremarkable. The change at the base of the tongue and in the vallecula described in the CT scan cannot be traced by inspection or palpation. Smooth mucosal conditions on all sides. Now adjust the oropharynx with the McIvor mouth spatula and remove the whitish build-up on the posterior palatal arch with a safety margin of 1 cm, using monopolar coagulation as well as scissors and bipolar forceps. Then take marginal samples. The main preparation is thread-marked for final histology. A resection is taken at the transition to the uvula. The marginal samples are also sent for final histology. If a non-in-sano resection is still present as part of the carcinoma in situ, this can be resected without any problems. The patient is also very well adjustable in the hypopharyngeal region, which would make laser resection of the mass in the piriform sinus possible. However, if an invasive carcinoma is found on histology in the posterior palatal arch, primary radiochemotherapy should be considered in the case of field cancerization.