In patients who suffer from laryngeal fibrosis or stenosis, the usual retraction and exposure for laryngeal surgery is unsatisfactory. We demonstrate a trans-nasal fiberoscopic laryngeal laser surgery on a patient suffering from bilateral vocal fold paralysis and laryngeal stenosis due to previous irradiation for hypopharyngeal cancer. The laryngeal surgical field under the nasopharyngoscope in both the supine and the prone positions was recorded and compared. The result demonstrates that in some circumstances, setting the patient in the prone position may facilitate laryngeal surgery and whenever possible, gravity can be used to facilitate a difficult procedure.