Sinonasal and skull base surgeon Murugappan Ramanathan discusses a case of a male in his mid-50s who presented unable to breathe out of his left nostril. During surgery, what was at first presumed to be polyps in the nose was diagnosed as a sinonasal inverted papilloma deeper in the sinuses. This reinforces the importance of frozen section pathology in cases with abnormal-appearing tissue, which can be concerning for benign or malignant tumors.