Tracheoscopy by the surgeon is extremely difficult in the case of a severely overhanging epiglottis, but can be performed on its own and shows unremarkable findings. Then intubation by the anesthesia colleagues and start with the flexible esophagoscopy: Advance into the stomach under continuous air insufflation. Now, after diaphanoscopy, insertion of the PEG tube in the usual manner without complications. No evidence of tumor or stenosis of the esophagus on retraction. Now insertion with the Kleinsasser D-tube in narrow conditions and inspection of the oropharynx. The previously described ulcerated mass of the left tonsil is seen, which spreads into the left base of the tongue in the area of the glossotonsillar groove. Palpatory findings are coarse here. The exophytic growth ends clearly in front of the uvula. Otherwise free hypopharynx and endolarynx, as far as visible also free. Esophageal entrance free. Now insert the tonsil plug and mark the resection margins. The tumor is first removed with the electric needle in the area of the palatal arch while preserving the uvula. To do this, the posterior palatal arch is cut through to the posterior pharyngeal wall. The tumor is now gradually cut around, partly electrically and partly cold, in the direction of the lateral pharyngeal wall. Now the tumor is cut around anteriorly in the base of the tongue and up to the middle of the tongue base so that the tumor becomes more mobile. The tumor can be easily removed both cranially and in the area of the base of the tongue; laterally, resection is more difficult. It is resected to such an extent that the submandibular gland is exposed and a larger vessel can be seen. In between, repeated bipolar coagulation and then removal of the tumor en bloc. The tumor is suture-marked as follows: Long/long suture corresponds to the lateral deep resection margin; ...... short/short to the base of the tongue at the caudal margin; short/long to the cranial margin in the area of the palatal arch. Extensive hemostasis is now performed and samples are taken from the margins as follows: Once from the lateral resection margin in the area of the submandibular gland, then in the area of the deep lateral base of the tongue and in the area of the left palatal arch. These samples are taken for final histological evaluation. Once again, extensive hemostasis is performed and a TachoSil sponge is placed on the vessel and the exposed gland. Unblocking and checking again after several minutes shows no renewed bleeding. Now transfer to tracheotomy: instillation of 4 ml xylocaine with adrenaline. Modified Kocher collar incision and visualization of the subcutaneous tissue, transection of the same and preparation of the trachea. Undermining of the thyroid isthmus and its removal after repositioning. Insertion into the trachea and, after placement of a Björk flap, placement of a plastic tracheostoma in the usual manner. Conclusion: Tumor was resected enorally as far as possible. If tumor remains laterally and this is proven in the histological tissue samples, further tumor resection from the outside with flap coverage is unavoidable. Otherwise, neck dissection should be planned on both sides in 14 days.