Safety and Accuracy of Minor Salivary Gland Biopsy in Sjögren’s Disease: A Retrospective Analysis of 202 Patients

Objective

Minor salivary gland biopsy (MSGB) is a standard procedure in the diagnosis of Sjögren’s disease (SD). Biopsy techniques using a vertical or horizontal mucosal incision are applied in daily practice. Here we aim to quantify and classify adverse events (AEs) of MSGB using vertical incision technique.

Patients and Methods

Medical records of patients with suspected SD who underwent MSGB at our outpatient clinic between January 2014 and April 2024 and had follow-up visits were analyzed. The MSBG consisted of a 1 cm linear vertical incision in the oral mucosa of the lower lip to collect up to five lip salivary glands.

Results

202 of 257 patients undergoing MSGB, met inclusion criteria. Median follow-up time was 16.5 (0.5-124.0) months. Four biopsies (2%) did not yield sufficient material for histological analysis. One serious adverse event (0.5%), local persistent paresthesia, and two moderate adverse events (1.0%), including one case of prolonged bleeding and one unclassified event, were reported. Mild AEs occurred in 18 patients (8.9%). Local discomfort after biopsy affected 32 patients (15.8%). AEs subsided either during or up to 2 hours after biopsy in 14 patients (6.9%) and in 38 patients (18.8%) within three weeks, respectively.

Conclusions

MSGB with vertical incision technique has a very low frequency of serious and long-term complications with a success rate of 98%.

Key messages

• Minor salivary gland biopsy with lateral vertical incision technique has a success rate of 98%.

• Serious complications occurred less frequent than previously reported for horizontal incision technique.