Patient with .... Leukoplakia left tongue margin, before excision biopsy Performing a panendoscopy. Insertion of the esophagoscope into the stomach. Inconspicuous conditions there. No evidence of a tumor in the area of the esophagus on retraction. Pharyngoscopy: insertion of the Kleinsasser tube. Inconspicuous mucosa can be seen in the area of the piriform sinus on both sides, the postcricoid region, the entrance to the esophagus, the posterior and lateral walls of the oropharynx, the base of the tongue of the vallecula and the lingual epiglottis. Finally, insertion of the rigid tube into the larynx. Performing a microlaryngoscopy: This reveals normal conditions in the area of the entire larynx. Now insertion of a mouth blocker and a tongue retaining suture. Exophytic masses with leukoplakic changes are clearly visible on the left side of the tongue. These are completely cut around with the electric needle, clinically removed in toto, also in the area of the tumor base with a safety margin. The tissue is sent to the pathology department for definitive histology. Finally, hemostasis is performed again with H202 swabs and bipolar coagulation. No more bleeding. End of the procedure. Further procedure: Wait for the definitive histology. Depending on the depth of entry and ultrasound findings, plan neck dissection if necessary. Patient goes to IOI for monitoring due to the pronounced pulmonary artery stenosis.