The case being presented is that of an elderly diabetic male with a mediastinal tumor extending from his mid-neck to aortic arch. Be-cause of sequential paralysis of both vocal cords, a sarcoma was suspected. The patient had significant coronary artery disease and underwent coronary artery bypass grafting. Several weeks later, he had bilateral posterolateral thoracotomies to excise the tumor. Several months later, when vocal cord function did not im-prove, he underwent laser cordotomy to increase his glottic aper-ture. The patient is shown at presentation, following CABG, at bilateral thoracotomy, and following his laser cordotomy. Many posed views are shown illustrating technical details of interest to practicing surgeons.