62-year-old patient, in good general condition.

Medical history: Previous chemoradiotherapy (CRT) for a T3N2c right tonsillar tumour, complicated by osteoradionecrosis with mandibular fracture, requiring maxillofacial surgery.

Current situation: mild dysphagia

Flexible endoscopy: Midline exophytic lesion arising from the infrahyoid epiglottis, suitable for excision. Dysplasia of the left aryepiglottic fold (AEF), to be assessed intraoperatively. Left hemilaryngeal paralysis, possibly secondary to the oesophageal carcinoma.

T1N0 supraglottic tumour.

PET- CT: No abnormalities in the oropharynx. Oesophageal tumour identified on CT and PET scan; awaiting biopsy and further work-up.

MTB: Mild trismus, although the patient is edentulous and wears removable dentures. Transoral exposure appears feasible.

The patient has been counselled regarding transoral laser microsurgery (TLM) in the first step without neck dissection, as both sides of the neck have previously received radiotherapy.