Introduction

Moscow is both a medical and technological hub in Russia, and otorhinolaryngology (ENT) care here reflects rapid adoption of modern surgical technologies and contemporary perioperative practices. This article reviews the key innovations shaping ENT surgery in Moscow, how they are implemented in hospitals and clinics, training and regulatory aspects, current challenges, and what patients should know when seeking care.

Key modern technologies and practices in ENT

— Endoscopic sinus and skull-base surgery
— High-definition rigid endoscopes, angled optics and high-flow suction enable minimally invasive functional endoscopic sinus surgery (FESS) and endonasal skull-base approaches.
— Benefits: reduced morbidity, shorter hospital stays, better visualization of complex anatomy.

— Image-guided surgery (IGS) / surgical navigation
— CT- or MRI-based navigation systems integrate preoperative imaging with intraoperative tracking for safer work near the orbit, skull base and major vessels.
— Particularly valuable for reoperations, extensive polyposis, and tumor resections.

— Intraoperative imaging
— Cone-beam CT and intraoperative CT facilitate immediate verification of placement (e.g., implants, sinus clearance) and reduce revision rates.
— Used selectively in tertiary centers and specialized clinics.

— Powered instrumentation and microdebriders
— Rotary microdebriders and ultrasonic devices allow precise tissue removal with reduced bleeding compared with cold steel in many procedures.

— Balloon sinuplasty
— Minimally invasive dilation of sinus ostia for selected chronic rhinosinusitis patients, often performed as day-surgery.

— Transoral robotic surgery (TORS) and advanced endoscopic tools
— Robotic platforms (available in some tertiary and private centers) enhance access for phonosurgery, oropharyngeal tumor resections and selected skull-base cases.
— Flexible endoscopic and laser systems expand possibilities in laryngeal and hypopharyngeal procedures.

— Laser and energy-based laryngeal surgery
— CO2 and KTP lasers, plasma-assisted techniques and high-frequency devices permit precise microsurgery for vocal fold lesions and stenosis.

— Cochlear implants and hearing rehabilitation
— Modern multichannel cochlear implants, bone-anchored hearing systems and middle-ear implants are widely performed in Moscow centers; hybrid electro-acoustic solutions are increasingly available.
— Intraoperative neural response telemetry improves placement and early programming.

— Intraoperative neuromonitoring (IONM)
— Facial nerve, lower cranial nerve and vagus monitoring reduce nerve injury risk in parotid, skull-base and lateral skull procedures.

— 3D printing and patient-specific planning
— Preoperative 3D models, surgical guides and custom implants aid complex reconstructions (temporal bone, skull base, facial skeleton).

— Augmented reality (AR), virtual reality (VR) and simulation
— VR simulators and AR overlays increasingly used in training, preoperative planning and patient counseling.

— Cold plasma and novel wound technologies
— Cold atmospheric plasma for decontamination and faster mucosal healing; advanced hemostatic agents and dressings improve outcomes.

— Telemedicine and remote follow-up
— Remote triage, postoperative wound checks and audiology follow-up have grown after the COVID-19 pandemic, improving access for patients outside Moscow.

— Enhanced recovery and multimodal perioperative care
— ERAS principles—optimized analgesia, early nutrition, shorter fasting and mobilization—applied to major head and neck surgeries to shorten hospital stay.

— Integrated medical-surgical management
— Multidisciplinary care—rhinology, allergy/immunology, audiology, speech and swallowing therapy, oncology—ensures personalized treatment plans. Use of biologics for severe chronic rhinosinusitis with nasal polyps is part of combined medical-surgical strategies.

Implementation and where to find these services in Moscow

— Academic and public hospitals: major medical universities and federal centers (for example, clinics affiliated with Sechenov University and Pirogov University) typically lead complex skull-base, cochlear implant and oncologic programs.
— Specialized federal research institutes and municipal ENT