Is intraoperative margin sampling necessary in inverted papilloma resection?

Eran Glikson*, Alberto Dragonetti, Ethan Soudry, Noa Rozendoren, Eran E. Alon, Roee Landsberg, Shay Schneider, Lev Bedrin, Francesco Mozzanica, Chiara Bulgheroni, Arkadi Yakirevitch

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Pages (from-to)2935-2942
Number of pages8
JournalEuropean Archives of Oto-Rhino-Laryngology
Issue number6
StatePublished - Jun 2022


  • Endoscopic endonasal resection
  • Frozen section
  • Inverted papilloma
  • Surgical margins


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