To demonstrate whether the regional recurrence (RR) of squamous cell carcinoma (SCC) of the nasal cavity is higher than previously suspected. Data Sources: Original articles, including a previously published series from our institution, were identified from systematic searches of the MEDLINE database. Study Selection: Studies that analyzed tumors other than SCC or tumors from sites other than the nasal cavity were excluded. Studies that did not report an RR were also excluded. Data Extraction: Studies identified by the literature search were reviewed by a single reviewer (W.C.S.), and studies not excluded were reviewed for data extraction by 2 reviewers (W.C.S. and M.Y.C.). Data Synthesis: From the 23 studies reviewed, the average weighted percentage RR for SCC of the nasal cavity was 18.1% (95% confidence interval, 13.4%-22.8%). Conclusions: Currently, few authors advocate elective treatment of the neck in patients with high-risk SCC of the nasal cavity. The results of this systematic review and meta-analysis demonstrate that the RR of this entity may be higher than previously suspected. Because many studies included other histopathologies or analyzed recurrence data from tumors of multiple subsites, a true RR for SCC of the nasal cavity has not been firmly established. Now that a uniform staging system exists for nasal cavity cancers, better prospective analysis of these tumors will be available. The authors suggest that the risk of RR of certain high-risk SCCs of the nasal cavity to the lymph nodes, including the perifacial and upper cervical lymphatics, may approach the frequently cited 20% risk suggestive of consideration for elective regional therapy.
The CO2 laser fiber did not show an advantage in operative time. The CO2 laser fiber did show better outcomes in the areas of blood loss, bipolar cautery use, and intraoperative margins needed.
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