Minor Salivary Gland Biopsy

When it is needed

Dry eyes and dry mouth are common and usually not autoimmune — medication, age, screen use and diabetes all cause them. Sjögren's syndrome is diagnosed on a combination of symptoms, tear and saliva measurements, and antibodies (anti-Ro/SSA in particular).

The difficulty is that a substantial proportion of people with genuine Sjögren's are antibody-negative. In those patients the biopsy is what separates autoimmune disease from ordinary dryness — and the distinction matters, because Sjögren's carries risks that ordinary dryness does not, including nerve, lung and lymphoma-related complications that need monitoring.

What happens

The inner surface of the lower lip is numbed with local anaesthetic. A small incision gives access to several minor salivary glands, a few of which are removed and sent for examination. The incision is closed with fine dissolvable sutures. The whole procedure takes around twenty minutes.

What the pathologist looks for

Clusters of lymphocytes around the glands, counted as a focus score. A focus score at or above the accepted threshold is one of the formal classification criteria for Sjögren's syndrome.

Recovery

Expect numbness for a few hours, mild swelling and tenderness inside the lip for a few days, and soft foods for the first day. A small area of altered sensation at the site is possible and usually settles.

Conditions this is used for

These are the conditions in which Minor Salivary Gland Biopsy forms part of the assessment or the treatment plan. It is not a complete list, and whether it applies to you is decided at consultation.

• Sjögren's Syndrome

Whether a procedure is appropriate is decided during consultation, based on your symptoms, examination and existing reports.