Transfer of the patient to the operating theater and positioning of the patient. Introductory consultation with the anesthesia department and performance of the team time-out. Problem-free intubation with Cormack I and inconspicuous tracheoscopy. Now start slinging the tongue and PE from the mass on the right edge of the tongue. This is approx. 3 x 2 ˝ cm in size and extends from the middle third of the tongue to the posterior third of the tongue, the base of the tongue itself is free, as well as in the anterior area of the mass down to the floor of the mouth. The right Wharton's duct is congested, the tongue is still mobile, no midline crossing or infiltration of the tonsillar lobe can be seen. Now esophagogastroscopy. Here the stomach is unremarkable and non-irritable, with no evidence of bleeding or a mass. Any fluid present is aspirated and the stomach is pumped out. The oesophagus is unremarkable. Now enter with the small bore tube C and inspect the rest of the oral cavity and palpate the tonsils and base of the tongue. These are unremarkable, the vallecula is clear and the epiglottis is also unremarkable. With good adjustability, the piriform sinuses are pre-mirrored and expanded. These are inconspicuous on both sides and without irritation, the posterior and lateral pharyngeal walls and the postcricoid region are also inconspicuous, the vocal folds can be adjusted well on both sides up to the anterior commissure and are also inconspicuous here. In the case of invasive squamous cell carcinoma in the frozen section, the tongue is now snared and the resection borders are marked with the ultrasonic knife. First, both papillae are dilated with the dilator and saliva is massaged out. This is possible on both sides, and it is also possible to insert a myrtle leaf probe on both sides, assuming that the duct is intact on both sides. After insertion of the myrtle leaf probe, the tumor is successively cut around with the ultrasonic knife, with palpation and inspection of the tumor extension. The tumor is successively and further removed. Identification of the lingual nerve and protection of this. However, smaller divisions of the nerve must be resected as they run directly into the tumor. Easy removal and suture marking of the tumor. Sending for frozen section. The mass at the left nasal entrance is also biopsied and sent for frozen section. This also shows a nasal entrance carcinoma, which is why resection, suture marking and removal of marginal samples are also performed here. In the small defect of the cartilage on the left side, a small full-thickness skin graft is taken from the right neck and, after notification of the frozen section (R0), this is sutured onto the left nasal entrance as a patch. The result is very good. Now feedback from the frozen section. In the case of R1 resection, the anterior floor of the mouth is resected again. These resections or margin samples are now tumor-free (R0). For this reason, the tongue is primarily closed with Vicryl 3-0. Again, care is taken to ensure that the duct is not damaged, saliva can be expressed without any problems and the duct can still be easily probed. Insertion of a nasogastric tube and completion of the operation. Conclusion: Simultaneous cT2 tongue margin carcinoma and cT1 nasal entrance carcinoma on the left side with suspected cN1 cM0. The nasogastric tube should be left in place for at least 3 days. After receiving the final histology, the patient should be presented to the interdisciplinary tumor conference. The necessity of a unilateral or bilateral neck dissection should also be discussed here. Regular gland massage and administration of Sialagoga should also be carried out. The antibiotic treatment started intraoperatively with 3 g Unacid should be continued for 1 week. The patient received a single shot of SDHS 250 mg i.v. intraoperatively. The stitches on the nose should be removed after 7 days, the stitches on the neck after 10 days.