Squamous cell carcinoma of the anterior nasal cavity: a dual institution review.

Thirty-two patients with squamous cell carcinoma of the anterior nasal cavity were identified at two university hospitals. A retrospective review was conducted to identify clinical presentation, initial therapy, recurrence rates, and factors affecting survival. Treatment included surgery (n = 15), radiation therapy (n = 9), or combination therapy (n = 8). The primary lesions involved either the septum, vestibule, columella, anterior floor, or a combination of these subsites. The primary tumor involved a single nasal subsite in 22 patients and multiple nasal subsites in 10 patients. All patients had de novo squamous lesions, and all tumors were staged N0 at initial diagnosis. Six patients received prophylactic neck irradiation, and none underwent elective neck dissection. Overall, 18 (56%) patients had recurrent disease after primary therapy (5 local and 13 regional). The 5-year disease-free survival was 42%, and the 5-year overall survival was 50%. None of the patients receiving prophylactic neck irradiation had a regional recurrence. Involvement of 2 or more nasal subsites significantly decreased survival (P < 0.05). Squamous cell carcinoma of the anterior nasal cavity is an aggressive disease, and combined therapy initially with strong consideration for prophylactic radiation to the facial and cervical lymphatics is advocated.

Correlation of allergy and severity of sinus disease.

Allergy is an important consideration in the evaluation of patients with rhinosinusitis. Several studies have addressed staging systems for rhinosinusitis based on the extent of disease present on computed tomography (CT) scanning. The severity and extent of sinus disease present on CT imaging helps guide decisions regarding medical and surgical treatment options. This study evaluates the severity of sinus disease in allergic and nonallergic patients. A total of 42 patients at our institution underwent both modified RAST and coronal sinus CT scan in the evaluation of their rhinosinusitis symptoms. A single, blinded staff neuroradiologist staged all 42 CT scans using the Lund-Mackay staging system. None of the patients had undergone sinus surgery. Age, sex, co-morbidities, asthma, smoking, RAST score, total IgE, and CT staging score were analyzed. Allergic patients were found to have a higher CT scan score (mean score = 12) when compared to nonallergic patients (mean score = 6), indicating more extensive sinus disease (p = 0.03). We conclude that allergy is a significant factor in the development of rhinosinusitis, and allergic patients are more likely to demonstrate advanced disease on CT scan when compared to nonallergic patients.