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Early-stage innovation report
Use of a smart lip holder for minimally invasive minor salivary gland biopsy
  1. Alexandre Dumusc1,
  2. Bettina Bannert2,
  3. Florian Kollert3,
  4. Jorge Álvarez-Troncoso4,
  5. Thomas Hügle1
  1. 1 Rheumatology, Lausanne University Hospital, Lausanne, Switzerland
  2. 2 Rheumatology, University Hospital Basel, Basel, Switzerland
  3. 3 Rheumatology, Inselspital University Hospital Bern, Bern, Switzerland
  4. 4 Unidad de Enfermedades Autoinmunes Sistémicas, Hospital Universitario La Paz, Madrid, Spain
  1. Correspondence to Professor Thomas Hügle, Rheumatology, Lausanne University Hospital, Lausanne 1011, Switzerland; thomas.hugle{at}chuv.ch

https://doi.org/10.1136/bmjinnov-2020-000519

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    Summary box

    What are the new findings?

    • We describe a novel instrument that permits a rapid and safe minor salivary gland biopsy in cases of suspected Sjögren’s syndrome or other diseases.

    How might it impact on healthcare in the future?

    • Minor salivary gland biopsy can be performed by a single person

    • The intervention is less invasive and more rapid

    • No neurological complications such as numbness were observed

    Introduction

    Sjögren’s syndrome (SS) is a chronic autoimmune condition with a prevalence of up to 1%.1 Salivary gland biopsy showing focal lymphocytic sialadenitis (focus score of ≥1) is required to fulfil the classification criteria for SS in seronegative patients, which is the case in up to 30%.2 Salivary gland biopsy is also an important tool to diagnose or exclude other systemic diseases causing sicca symptoms, such as sarcoidosis, amyloidosis, Mikulicz’s disease or IgG4-related disease. So far, there has been no standard technique for salivary gland biopsy. Minor salivary gland biopsy (MSGB) of the lower lip is widely used due to its low invasiveness, and has a sensitivity ranging from 63% to 93% and a specificity of >90% reported in most studies.3 In contrast to biopsy of the parotid gland, fascial nerve damage does not occur in MSGB. Yet it can lead to transient local paraesthesia of the lower lip in up to 11% of the interventions, at least when including different techniques regarding length and direction of incision or punch biopsy.4 Newer, less invasive techniques applying transcutaneous pressure manually or using devices such as adapted chalazion forceps5 reduce permanent neurological complications to 0.1%.6 7 In a study, using …

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