Once again, the size C and D small bore tube is used. The tumor is visible from the middle third to just before the commissure. Overall setting suboptimal. Therefore, resection from the outside. Repositioning for laryngeal resection: injection of a total of 8 ml Ultracaine 1% with adrenaline in the prelaryngeal area. Sterile draping after skin disinfection. Z-shaped skin incision. Subsequent exposure of the infrahyoid musculature. This is split medially or dissected to the side. Exposure of the laryngeal skeleton. Formation of a soft tissue perichondrium flap, which is started parapharyngeally on the left and dissected over the front edge of the larynx. Subsequent thyrotomy. Opening of the larynx. The tumor can be seen from the front and reaches just in front of the commissure. Due to the proximity, a small, triangular piece of cartilage is removed from the right side. The perichondrium is then pushed away from the cartilage on the right over the entire length of the vocal fold. This is due to the deep infiltration of the tumor. No breakthrough through the perichondrium. Resection of the vocal fold up to the processus vocalis of the arytenoid cartilage, also including parts of the pocket fold, as the tumor grows somewhat into the ventriculus laryngeus. The tumor is then removed in a specimen. Suture marking. A marginal sample is taken from the left front at the transition to the left vocal fold, another marginal sample from the arytenoid region. Subsequent careful hemostasis. In the frozen section, both tumor and marginal samples in healthy tissue, thus R0 resection. The left vocal fold is now refixed to the cartilage using a 4-0 Vicryl suture. Subsequently, the most careful hemostasis again, no bleeding for a long time after hemostasis and Suprarenin swab insertion. Then suturing of the thyroid cartilage using Vicryl 3-0 sutures. Repositioning of the perichondrium soft tissue flap and suturing to the opposite side with 4-0 Vicryl single-button sutures. Complete closure. Subsequent suturing of the infrahyoid musculature using 3-0 Vicryl single button sutures. This with insertion of a flap. Subsequent layered wound closure. Followed by a light pressure bandage. The procedure was completed without complications. Overall cT1 laryngeal carcinoma, more cT1a than b, but with some proximity to the anterior commissure. Due to the less than optimal overview, resection from the outside. Please arrange another check-up or follow-up MLE in 8 to 12 months.