Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-23T03:39:26.675Z Has data issue: false hasContentIssue false

Dry surgical field minor salivary gland harvest using a chalazion clamp for sicca syndrome

Published online by Cambridge University Press:  22 April 2019

C Wijaya*
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, St Vincent's University Hospital, Dublin, Ireland
R R Ramli
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, St Vincent's University Hospital, Dublin, Ireland
S G Khoo
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, St Vincent's University Hospital, Dublin, Ireland
*
Author for correspondence: Mr Clifton Wijaya, Department of Otorhinolaryngology Head and Neck Surgery, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland E-mail: [email protected] Fax: +353 1 221 3996

Abstract

Background

Sjögren's syndrome is a rheumatological condition. Diagnosing Sjögren's syndrome can be challenging given the overlapping nature of clinical presentations. Currently, minor salivary gland biopsy is considered the definitive test for diagnosing Sjögren's syndrome. Various surgical techniques have been described, targeting biopsy of minor salivary glands from the lower lip. Identification of minor salivary glands is often difficult because of bleeding. One common complication of minor salivary gland biopsy is lip paraesthesia from iatrogenic sensory nerve injury.

Objectives

To describe a minor salivary gland biopsy technique in a bloodless operative field using a chalazion ophthalmic clamp under local anaesthesia, and to report our clinical outcomes.

Methods

A prospective study was performed on patients who underwent minor salivary gland biopsy using a chalazion ophthalmic clamp between July 2017 and April 2018.

Results

The study included 23 patients. The histopathological reports positively identified minor salivary glands for all patients. In nine cases, the histological findings were positive for Sjögren's syndrome. No lip paraesthesia complications were reported post-operatively.

Conclusion

This technique facilitates a superior yield, ensures adequate sampling of appropriate glands for histopathological analysis, and minimises the complications associated with traditional techniques.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited, 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Mr C Wijaya takes responsibility for the integrity of the content of the paper

Presented at the Royal Academy of Medicine in Ireland (‘RAMI’) Section of Otorhinolaryngology – Head and Neck Spring Meeting, 21 April 2018, Tullow, Ireland.

References

1Ng, W-F, ed. Sjögren's Syndrome. Oxford: Oxford University Press, 2016;1011Google Scholar
2Vitali, C, Bombardieri, S, Jonsson, R, Moutsopoulos, HM, Alexander, EL, Carsons, SE et al. Classification criteria for Sjögren's syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. Ann Rheum Dis 2002;61:554–8Google Scholar
3Langegger, C, Wenger, M, Duftner, C, Dejaco, C, Baldissera, I, Moncayo, R et al. Use of the European preliminary criteria, the Breiman-classification tree and the American-European criteria for diagnosis of primary Sjögren's Syndrome in daily practice: a retrospective analysis. Rheumatol Int 2007;27:699702Google Scholar
4Shiboski, SC, Shiboski, CH, Criswell, L, Baer, A, Challacombe, S, Lanfranchi, H et al. American College of Rheumatology classification criteria for Sjögren's syndrome: a data-driven, expert consensus approach in the Sjögren's International Collaborative Clinical Alliance cohort. Arthritis Care Res (Hoboken) 2012;64:475–87Google Scholar
5Daniels, TE. Labial salivary gland biopsy in Sjögren's syndrome. Assessment as a diagnostic criterion in 362 suspected cases. Arthritis Rheum 1984;27:147–56Google Scholar
6Garcia, RL, Davis, CM. Chalazion clamp for dermatological surgery. Arch Dermatol 1970;102:693Google Scholar
7Guellec, D, Cornec, D, Jousse-Joulin, S, Marhadour, T, Marcorelles, P, Pers, JO. Diagnostic value of labial minor salivary gland biopsy for Sjögren's syndrome: a systematic review. Autoimmun Rev 2013;12:416–20Google Scholar
8Pijpe, J, Kalk, WW, van der Wal, JE, Vissink, A, Kluin, PM, Roodenburg, JL. Parotid gland biopsy compared with labial biopsy in the diagnosis of patients with primary Sjogren's syndrome. Rheumatology (Oxford) 2007;46:335–41Google Scholar
9Caporalli, R, Bonacci, E, Epis, O, Bobbio-Pallavincini, F, Morbini, P, Montecucco, C. Safety and usefulness of minor salivary gland biopsy: retrospective analysis of 502 procedures performed at a single center. Arthritis Rheum 2008;59:714–20Google Scholar