return to: Lip biopsy for minor salivary gland (biopsy for Sjogren's syndrome); Lip Biopsy of Minor Salivary Gland Histopathology for Sjogren's Syndrome (sjogren / sjogrens); Sialograms and Sialography

see:Mental nerve and efforts to avoid numb lip from biopsy of minor salivary glands for Sjogrens;  Complication From Lip Biopsy for Sjogrens with Mucocele Formation (Granulation Tissue)

Procedure: Lip biopsy (8 minor salivary gland aggregates) sent to rule out Sjogren's syndrome

Preop Diagnosis: Sicca syndrome rule out Sjogren's syndrome

Postop Diagnosis: Same

Anesthesia: 1 cc of 2% lidocaine with 1 or thousand epinephrine to the left gingival buccal sulcus in between the 2 premolars in effort to block mental nerve

Description of Procedure: Following identification the patient informed consent and a brief timeout in the minor room following the above-mentioned anesthesia with a brief prep with Betadine swab the left lip was everted and secured using the chalazion clamp

With a chalazion clamp in place and incision made canted slightly to follow the course of mental nerve branches was made through mucosa allowing for view of multiple small minor salivary glands teased out with small Adson forceps grabbing the corner of the minor gland and scalpel used to gently stripped the gland away from adjacent tissue.  

A single four 0-0 Vicryl was placed in the midportion of the wound approximating mucosal edges incorporating a small bit of underlying muscle to obliterate the dead space followed by two additional 5-0 Vicryl's placed with care to avoid trauma to underlying branches of the mental nerve. 

She tolerated the procedure well with estimated blood loss less than 5 cc and was observed in clinic before discharged home with instructions use ice pack oral rinses potentially adding peroxide rinse and spit.

References

Wijaya C, Ramli RR, Khoo SG.Dry surgical field minor salivary gland harvest using a chalazion clamp for sicca syndrome. J Laryngol Otol. 2019 May;133(5):419-423. doi: 10.1017/S002221511900077X. Epub 2019 Apr 22.

alternative approach we (HH) do not employ: Guevara-Gutiérrez, E. , Tlacuilo-Parra, A. & Minjares-Padilla, L. M. (2001). Minor Salivary Gland Punch Biopsy for Evaluation of Sjögren’s Syndrome. JCR: Journal of Clinical Rheumatology, 7 (6), 401-402.