Videos of Surgical Procedures in Dermatology
Minor Salivary Gland Biopsy in Dermatology
Biopsia de glándulas salivales menores en Dermatología
D. Ramos-Rodríguez
, I. Gracia-Darder, A. Bauzá Alonso
Corresponding author
Servicio Dermatología, Hospital Universitari Son Espases, Palma, Mallorca, Spain
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"apellidos" => "Bauzá Alonso" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio Dermatología, Hospital Universitari Son Espases, Palma, Mallorca, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Biopsia de glándulas salivales menores en Dermatología" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 578 "Ancho" => 2500 "Tamanyo" => 199860 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Chalazion forceps placed on the lower lip. (B) Surface dissection. (C) Suture before withdrawal of the chalazion forceps<span class="elsevierStyleItalic">.</span></p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Introduction and Indications for the Technique</span><p id="par0005" class="elsevierStylePara elsevierViewall">Minor salivary gland biopsy is a procedure that is included in the diagnostic criteria for Sjögren syndrome. It can also prove useful for the diagnosis of various diseases such as amyloidosis, sarcoidosis, neonatal hemochromatosis, and lymphoma in patients with Sjögren syndrome.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">1,2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The technique was first described by Chisholm and Mason in 1968, although many modifications to the original technique have been proposed. In the explanatory video (<a class="elsevierStyleCrossRef" href="#sec0035">video 1</a>), we describe salivary gland biopsy performed with chalazion forceps<span class="elsevierStyleItalic">,</span> an instrument used in ophthalmological surgery.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Description of the Technique</span><p id="par0015" class="elsevierStylePara elsevierViewall">Below, we set out a series of factors to be considered when applying this technique.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Area to be biopsied: The ideal site is the mucous membrane of the lower lip because it is easy to access and work with and the number of salivary glands is higher. The midline of the buccal vestibule should be avoided because of the lower number of glands in the area (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Procedure: The area to be biopsied should be sterilized with chlorhexidine 0.12%–0.20% or povidone iodine. The chalazion forceps are placed in position and pressed to avoid bleeding. A line is then drawn parallel to the vermilion border (approximately 1<span class="elsevierStyleHsp" style=""></span>cm). A superficial incision is made to reveal the minor salivary glands (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B). Between 6 and 8 glands should be obtained in order to ensure a sound histopathology study.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Suture: The first sutures should be placed before removing the chalazion forceps (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C). Reabsorbable suture should be used.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Immediately after the procedure, we apply folded gauze at the biopsy site and instruct the patient to maintain pressure in the area for 15–20<span class="elsevierStyleHsp" style=""></span>min; we also provide postoperative instructions in writing. The patient is recommended to avoid hot drinks, smoking, and vigorous rinsing for 24–48<span class="elsevierStyleHsp" style=""></span>h after the intervention. Although we use reabsorbable sutures, the patient is asked to attend to have them removed after 7–10 days if they do not fall out by themselves.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Complications</span><p id="par0040" class="elsevierStylePara elsevierViewall">The various surgical complications include bleeding, hematoma, wound dehiscence, local inflammation, surgical bed infection, pyogenic granulomas, and hypertrophic scarring. However, the most common complication is local paresthesia.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">1,2</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Conclusions</span><p id="par0045" class="elsevierStylePara elsevierViewall">Minor salivary gland biopsy is a rapid, easy, and safe procedure in dermatology.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of Interest</span><p id="par0050" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:6 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction and Indications for the Technique" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Description of the Technique" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Complications" ] 3 => array:2 [ "identificador" => "sec0020" "titulo" => "Conclusions" ] 4 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflicts of Interest" ] 5 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0060" class="elsevierStylePara elsevierViewall">The following are the supplementary data to this article:<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>" "etiqueta" => "Appendix A" "titulo" => "Supplementary data" "identificador" => "sec0035" ] ] ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 578 "Ancho" => 2500 "Tamanyo" => 199860 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Chalazion forceps placed on the lower lip. (B) Surface dissection. (C) Suture before withdrawal of the chalazion forceps<span class="elsevierStyleItalic">.</span></p>" ] ] 1 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc1.mp4" "ficheroTamanyo" => 13292730 "Video" => array:2 [ "flv" => array:5 [ "fichero" => "mmc1.flv" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] "mp4" => array:5 [ "fichero" => "mmc1.m4v" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Minor salivary gland biopsy in Sjögren's syndrome: a review and introduction of a new tool to ease the procedure" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "P. Varela-Centelles" 1 => "J.M. Seoane-Romero" 2 => "M. Sánchez-Sánchez" 3 => "A. González- Mosquera" 4 => "P. Diz-Dios" 5 => "J. Seoane" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4317/medoral.19131" "Revista" => array:6 [ "tituloSerie" => "Med Oral Patol Oral Cir Bucal" "fecha" => "2014" "volumen" => "19" "paginaInicial" => "e20" "paginaFinal" => "e23" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23986014" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Salivary gland biopsy: a comprehensive review of techniques and related complications" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "G. Colella" 1 => "R. Cannavale" 2 => "A. Vicidomini" 3 => "A. Itro" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/rheumatology/keq225" "Revista" => array:6 [ "tituloSerie" => "Rheumatology" "fecha" => "2010" "volumen" => "49" "paginaInicial" => "2117" "paginaFinal" => "2121" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20660500" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/00017310/0000011400000002/v3_202302211823/S000173102201016X/v3_202302211823/en/main.assets" "Apartado" => array:4 [ "identificador" => "6159" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Videos de cirugía dermatológica" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/00017310/0000011400000002/v3_202302211823/S000173102201016X/v3_202302211823/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S000173102201016X?idApp=UINPBA000044" ]
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