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Updated: Oct 19, 2025
Intraoperative Assessment of Resection Margins in Oral Cavity Cancer: This is the Way
Published on: May 10, 2021
Is intraoperative margin sampling necessary in inverted papilloma resection?
Eran Glikson1,2, Alberto Dragonetti3, Ethan Soudry4,5
1Department of Otolaryngology Head and Neck Surgery, The Sheba Medical Center, Tel Hashomer, Israel. Eran.Glikson@sheba.health.gov.il.
Purpose:
To explore the association between intraoperative surgical margin sampling by the frozen sections and recurrence in inverted papilloma surgery.
Methods:
A multicenter, retrospective study of patients who underwent attachment-oriented IP resection in four tertiary care medical centers with a minimal follow-up of 36 months.
Results:
The study included 220 surgeries with a mean follow-up period of 49 months (range 36-204). The endoscopic approach was used in all but 4 cases; 73% of procedures were primary. Overall recurrence was 10.45% (n = 23). Squamous cell carcinoma was found in 5 cases (2.2%). Intraoperative margin sampling was obtained in 145 cases. There was no difference in the recurrence rate between frozen section and no-frozen section groups (p = 0.44). Furthermore, margin sampling in various sites of tumor origin, in cases with concomitant nasal polyps (p = 0.53) and in revision cases (p = 0.08) showed no correlation with recurrence. In 26 cases when the surgery was extended following a positive frozen section, there was a significantly higher recurrence rate (OR = 6.94).
Conclusions:
According to our results, intraoperative margin sampling did not affect the recurrence rate of IP, and therefore, its routine use should be questioned.
