Background and Objectives: Tumours of the lacrimal drainage system are rare and most located in the lacrimal sac. The authors of this study aimed to conduct a literature review to find out which malignant tumours most often occurred in the lacrimal sac and what symptoms patients reported in the early stages of the disease. Materials and Methods: The PubMed database was searched for papers published between 2019 and 2024. The inclusion criteria were presence of an abstract, malignant lacrimal sac tumours, papers written in English, studies on humans, and case reports. The exclusion criteria were lack of an abstract, pathologies other than malignant tumours, including benign tumours of the lacrimal drainage system, malignant tumours of a part of the drainage system other than the lacrimal sac, papers in languages other than English, studies not involving humans, and no case report. No gender criterion was used. Results: Based on the data available in the literature, 31 studies were included in the article, describing 34 cases of malignant lacrimal sac tumours. Moreover, a case of a 58-year-old patient diagnosed with non-Hodgkin lymphoma was presented. Conclusions: As a result of the literature analysis, it was impossible to find any symptoms reported by patients with lacrimal sac tumours that would clearly suggest their diagnosis.

Background/Objectives: Indwelling tracheoesophageal prostheses have a limited lifespan and require repeated replacement. We examined the determinants of the replacement interval. Methods: This study conducted a retrospective single-center analysis of 147 consecutive Provox replacements in 82 laryngectomized patients (June 2024–February 2026), reported according to STROBE, using mixed-effects and gap-time recurrent-event models. Results: Median device survival was 141 days. Prior irradiation was associated with a shorter interval (−38.3 days; 95% CI −67.2 to −9.3; p = 0.010), with a gradient by treatment intensity: the median survival was 179, 136, and 84 days after primary surgery, radiotherapy alone, and chemoradiotherapy (log-rank p < 0.001; cluster-robust hazard ratios 2.19 and 5.13 against primary surgery). A higher cumulative replacement burden—in terms of lifetime exchanges per patient, with a median of eight and range of 1–28—was also associated with shorter intervals (β = −3.70 days per additional lifetime exchange; 95% CI −5.84 to −1.57), but it summarizes the same event process as the outcome and is reported as a phenotype marker. Intervals ending in elective exchange were longer (β = 35.47 days; 95% CI 15.80 to 55.14), but in the primary recurrent-event model, containing only covariates fixed at interval start and retaining censored intervals, elective placement showed no association with device lifetime (HR 0.574; 95% CI 0.309–1.066; p = 0.079); between-patient heterogeneity remained substantial (θ = 0.452; p = 0.002). Complications occurred in seven of 147 procedures (4.8%), which were all managed without life-threatening events. Conclusions: Prior oncological treatment, particularly chemoradiotherapy, is associated with materially shorter device survival and can be used to identify patients likely to require more frequent exchange. Outpatient exchange appears safe. The association between elective replacement and longer intervals reflects conditioning inherent in comparing scheduled with failure-driven exchange, not a benefit of scheduling.

Hormonal factors, atopy, viral infections, gastroesophageal reflux, ischemic heart disease and swimming in a pool are believed to affect the development of primary acquired nasolacrimal duct obstruction (PANDO). It is suggested that patients with PANDO have more advanced inflammatory lesions revealed by the tomographic examination of the paranasal sinuses. The authors’ aim was to answer the question whether there is a connection between the chronic inflammation and disruption of the microbiome of the nasal cavity and sinuses and the development of inflammation in the lacrimal ducts. Pubmed.gov was the information source. Years reviewed included 2018 to 2023. Inclusion criteria included presence of an abstract, pathology of the nasolacrimal ducts, acute and chronic inflammation of the nasolacrimal ducts, papers written in English, studies on humans, publications regarding pathology of the lacrimal sac and paranasal sinuses, case report. The exclusion criteria included: lack of abstract, pathologies of other sections of the drainage system, pathology of the nasolacrimal ducts, other than chronic or acute inflammation, papers written in a language other than English, lack of case report. No gender criterion was used. Based on the data available in the literature, only 7 studies described the co-occurrence of pathologies of the lacrimal ducts and paranasal sinuses. Only 4 publications contained information on the microbiome and identified Streptococcus intermedius and Staphylococcus aureus, and in 2 cases no increase in pathological flora was revealed. The question about the relationship between the microbiome of the lacrimal sac and the paranasal sinuses and their mutual impact on the developing inflammation has not been answered, which, according to the authors, requires further research.

Background and objectives: Chronic rhinosinusitis (CRS) is a multifactorial inflammatory condition often associated with microbiome imbalance (dysbiosis). Recent studies highlight the potential role of synbiotics—combinations of probiotics and prebiotics—in modulating the microbiota and supporting immune responses. The authors of this study aimed to evaluate the impact of oral synbiotic supplementation on the sinus microbiota in patients undergoing endoscopic sinus surgery (ESS) for CRS. Materials and Methods: A total of 425 adult patients with CRS were enrolled in a multicenter retrospective study. According to EPOS 2020 guidelines, participants qualified for ESS. The intervention group (n = 194) received a synbiotic preparation for 6–8 weeks before and after surgery; the control group (n = 231) received no supplementation. Intraoperative and follow-up bacteriological samples were collected and analyzed. Statistical analysis included chi-square, t-tests, Wilcoxon tests, and ANOVA models. Results: Patients receiving synbiotics showed a significant reduction in pathogenic bacterial colonies postoperatively compared to the control group. In the synbiotic group coagulase-negative staphylococci appeared more frequently. Patients in the synbiotic group required significantly less postoperative antibiotic therapy (p < 0.05). Both groups exhibited an increase in Gram-positive and physiological flora and a decrease in Gram-negative bacteria following ESS. Conclusions: Synbiotic supplementation may beneficially influence the composition of the sinus microbiota and reduce pathogenic bacterial colonization following ESS. The findings suggest that synbiotics could serve as a supportive strategy in CRS treatment, potentially decreasing the need for postoperative antibiotics.

Background: Effective voice restoration after total laryngectomy relies heavily on indwelling tracheoesophageal prostheses. This study describes our institutional experience with Provox device replacements over five years. This retrospective single-center study analyzed 147 Provox voice prosthesis replacements performed in 82 laryngectomized patients between December 2024 and February 2026. We also used data from the full institutional cohort (1059 procedures and 899 intervals from May 2020 to March 2026). Mixed-effects models with a random intercept for each patient were applied to evaluate factors influencing the time interval between replacements and binary outcomes (complications, prosthesis size change, and elective vs expedited status). Results: In this retrospective single-center study, 82 laryngectomized patients underwent a total of 147 voice prosthesis replacements (June 2024–February 2026). Analysis of the full historical cohort (1059 procedures, 899 intervals from May 2020 to March 2026) revealed a mean interval between replacements of 122.5 days (95% CI 114.5–130.4). Mixed-effects linear regression showed that a higher cumulative number of prior procedures was associated with shorter subsequent intervals (β = −3.70 days per procedure; 95% CI −5.84 to −1.56; p < 0.001), whereas planned elective replacements significantly prolonged the interval (β = +35.47 days; 95% CI 15.80–55.14; p < 0.001) and were less likely to require size change (OR = 0.33; p = 0.034). The overall complication rate was low, with complications occurring in 7 out of 147 voice prosthesis replacement procedures (4.8%). Central leakage accounted for ~50% of unscheduled replacements, peripheral leakage for 25%, and dysfunction of prostheses without phonation for 19%. Complications occurred in 7 of 147 voice prosthesis replacements (4.8%). They included granulation tissue formation (n=2), prosthesis displacement (n=3), and swallowing of the prosthesis (n=2). All were managed successfully without life-threatening events, confirming the high safety of outpatient voice prosthesis exchange. Conclusions: The complication rate was notably low, with adverse events occurring in only 7 out of 147 voice prosthesis exchanges (4.8%). These findings confirm the high safety profile of outpatient voice prosthesis replacement in a tertiary ENT setting. Moreover, our results suggest that proactive, scheduled prosthesis replacements are preferable, as they are associated with significantly longer device lifetimes, a reduced need for unscheduled emergency procedures, and an overall safer clinical course.