(based on 1000 microlaryngosurgical interventions) V.N.Bakumov, B.O.Shahab, E.A.Nabatova, I.V.Andreeva, A.S.Drannikov, V.V.Uskova, V.V.Reznikov, V.M.Egorov, E.N.Gorlinskaya Volgograd Regional Clinical Hospital No. 1 From 1995 to 2003, 1000 microlaryngosurgical interventions were performed in the ENT department of the State Healthcare Institution “Volgograd Regional Clinical Hospital No. 1” in connection with various pathologies of the larynx. Structure of diseases: benign nodular formations - 348, Reinke's disease - 179, cicatricial stenosis, paresis, paralysis of the larynx - 138, chronic laryngitis and dyskeratosis - 127, laryngeal papillomatosis - 126, laryngeal cysts - 51, malignant neoplasms - 31. 490 patients (49%) were young 26-49 years old, middle-aged people - 240 (24%). 515 (51.5%) of the operated patients had high demands on the quality of the voice. Of the remaining patients, a significant proportion were children and adult patients, for whom the voice function is also important. We performed all endolaryngeal microsurgical interventions under general anesthesia, using combined endotracheal anesthesia with muscle relaxants in 947 patients (94.7%). In 53 children (5.3%), combined anesthesia with artificial ventilation by injection was used. We noted a more comfortable awakening in patients who used Diprivan in combination with fentanyl than with the traditionally used ultra-short-acting barbiturate, thiopental in combination with fentanyl. According to our data, voice recovery after endolaryngeal microsurgeries occurred in 97.2% of patients with benign tumors. Voice recovery was faster in patients who received a full course of postoperative rehabilitation, including inhalation and speleotherapy, and phonopedic exercises. We noted the high effectiveness of endolaryngeal microsurgery in patients with Reinke-Hayek disease, especially with unilateral lesions. Thus, in 92% of patients with unilateral disease, voice recovery after surgery occurred within 3 to 6 weeks. In patients with bilateral Reinke-Hayek disease, improvement in voice function after surgery was observed in 84% of patients. In the treatment of cicatricial stenosis, paresis, and paralysis of the larynx, microlaryngosurgery was used in combination with an external approach for laryngeal cavity exploration, excision of scar tissue and granulation, and control of the position of a silicone endolaryngeal stent. The combination of endolaryngeal surgery and external approaches significantly expanded treatment options and improved treatment outcomes in this group of patients. Improved respiratory function was noted in 77.8% of patients, allowing decannulation of the majority of them. In 92 (73.2%) patients with laryngeal papillomatosis, endolaryngeal microsurgery in combination with laser photodestruction of papillomas, immunocorrective and detoxifying therapy resulted in clinical recovery. The remaining patients in this group experienced longer periods of remission and a reduced number of relapses. We believe endolaryngeal microsurgery is essential in the treatment and follow-up of patients with chronic laryngitis and laryngeal dyskeratosis. It allows for a detailed examination of the laryngeal mucosa, determining the degree of keratinization in individual areas, the development of the vascular network, and the spread and boundaries of the pathological process. We routinely stain the laryngeal mucosa and all nodular lesions with a 1% toluidine blue solution, which enabled us to diagnose malignant tumors in 31 patients. The results of our study demonstrate the gentle nature and high effectiveness of using surgical optics when performing endolaryngeal microsurgical interventions. Postoperatively, we focused on progressively improving vocal function and developing and automating proper vocal skills. This reduced the number of relapses and the time it took to restore voice function in patients. Thus, our data confirm the high effectiveness of endolaryngeal microsurgery for various laryngeal diseases.