First induction of anesthesia by the anesthesia colleagues. Then rigid tracheoscopy with the O° scope by the surgeon. The trachea is free and non-irritated up to the carina with inconspicuous mucosa. Intubation by the anesthesia colleagues and then insertion of the Mc Ivor mouth blocker. Palpation of the tonsilloliths on both sides. Small palatine tonsils can be seen on both sides, with the left tonsil in the upper pole being slightly indurated in comparison to the sides. Demonstration of the findings to <CLINICIAN_NAME> and determination of the procedure. Tonsillectomy on the left should be performed first, followed by a frozen section. Subsequently, panendoscopy and nasopharyngeal curettage and removal of tongue base biopsies with clinically largely unremarkable left tonsil. Approach for left tonsillectomy: Exposure of the upper pole of the tonsil. The tonsil is successively and completely removed with bipolar and scissors. The posterior palatal arch is left completely intact. Laterally, the tonsil is released quite generously and caudally it is separated with the bipolar and scissors. The suture markings are made cranially and laterally. At the transition to the base of the tongue in the glossotonsillar groove, individual lymph follicles are still visible, which cannot be clearly assigned to the tonsil; these are resected separately with bipolar and scissors and submitted as histology glossotonsillar groove for frozen section assessment. There is no relevant bleeding after the tonsillectomy. Removal of the oral retractor and insertion of the flexible esophagogastroscope into the stomach in the typical manner. The gastric mucosa is completely free of irritation up to the pylorus and with inversion in the area of the cardia. Then carefully withdraw the esophagoscope with constant air insufflation. From 40 to 43 cm tooth row there are isolated erosions and at 42 cm from the tooth row a spherical exophytic, but overall smoothly limited mass. Demonstration of the findings to <CLINICIAN_NAME>, who recommends taking a forceps biopsy. Now advance the forceps over the working channel and take 3 representative samples from the exophytic mass. Finally, there is no relevant bleeding. Further retraction of the esophagoscope. Further cranial than 40 cm from the tooth row, the mucosa is completely normal and smooth. Now insert a mouth guard and inspect the rest of the oropharynx. The posterior and lateral walls of the oropharynx are free, as are the valleculae, the base of the tongue, which is symmetrically slightly hyperplastic, the lateral walls of the hypopharynx, the posterior wall of the hypopharynx and both piriform sinuses are free and can be freely unfolded. The esophageal inlet can also be freely unfolded with inconspicuous mucosal conditions. Direct laryngoscopy reveals an inconspicuous posterior and anterior commissure, the interary area is clear, as are the folds of the pouch, the morgue sinus and the vocal folds. The Mc Ivor mouth retractor is now inserted again and a velotractio is inserted on both sides. In the nasopharynx, slightly left-accentuated minor adenoids are seen, which are curetted out with the Beckmann ring knife under vision and sent for final histology. Finally, hemostasis with the bipolar. Removal of the mouth guard and insertion of the mouth guard and insertion of the Kleinsasser B-tube for re-inspection of the base of the tongue. There are no abnormalities here. Decision to take 2 representative samples each from the middle of the tongue base and the right and left sides. Final hemostasis with the monopolar. The frozen section result of <CLINICIAN_NAME> is now transmitted. It shows a basaloid squamous cell carcinoma of the left tonsil, which was resected practically on all sides R1. Discussion of the findings with <CLINICIAN_NAME> and acceptance of the operation by <CLINICIAN_NAME> for resection. This is done using the monopolar knife, bipolar and scissors. The resected specimen and representative marginal samples are submitted for final histology. The gl. submandibularis is now exposed laterocaudally. Final hemostasis with the bipolar. Removal of the swabs from the nasopharynx and, after re-inspection of the tonsil larynx and nasopharynx, termination of the operation with absolute hemostasis. Conclusion: V.a. cT2 cN1 basaloid squamous cell carcinoma of the left tonsil. After receipt of the final histology, neck dissection of the left side and PEG placement must definitely be planned with regard to an upcoming adjuvant radiochemotherapy. Please also note the histology from the esophageal mass 42 cm from the ZR. Depending on the final R status and swallowing function, a further resection and/or radial flap coverage must also be considered. According to <CLINICIAN_NAME>, flap coverage is required in the case of an R1 situation towards the palatal arch, medially and laterally. If there is an R1 situation towards the base of the tongue, another transoral resection could be performed.