Is intraoperative margin sampling necessary in inverted papilloma resection?
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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
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.
