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使用睑板腺囊肿夹在干燥手术视野下摘取小唾液腺用于干燥综合征治疗

Dry surgical field minor salivary gland harvest using a chalazion clamp for sicca syndrome.

作者信息

Wijaya C, Ramli R R, Khoo S G

机构信息

Department of Otorhinolaryngology Head and Neck Surgery,St Vincent's University Hospital,Dublin,Ireland.

出版信息

J Laryngol Otol. 2019 May;133(5):419-423. doi: 10.1017/S002221511900077X. Epub 2019 Apr 22.

Abstract

BACKGROUND

Sjögren's syndrome is a rheumatological condition. Diagnosing Sjögren's syndrome can be challenging given the overlapping nature of clinical presentations. Currently, minor salivary gland biopsy is considered the definitive test for diagnosing Sjögren's syndrome. Various surgical techniques have been described, targeting biopsy of minor salivary glands from the lower lip. Identification of minor salivary glands is often difficult because of bleeding. One common complication of minor salivary gland biopsy is lip paraesthesia from iatrogenic sensory nerve injury.

OBJECTIVES

To describe a minor salivary gland biopsy technique in a bloodless operative field using a chalazion ophthalmic clamp under local anaesthesia, and to report our clinical outcomes.

METHODS

A prospective study was performed on patients who underwent minor salivary gland biopsy using a chalazion ophthalmic clamp between July 2017 and April 2018.

RESULTS

The study included 23 patients. The histopathological reports positively identified minor salivary glands for all patients. In nine cases, the histological findings were positive for Sjögren's syndrome. No lip paraesthesia complications were reported post-operatively.

CONCLUSION

This technique facilitates a superior yield, ensures adequate sampling of appropriate glands for histopathological analysis, and minimises the complications associated with traditional techniques.

摘要

背景

干燥综合征是一种风湿性疾病。鉴于临床表现的重叠性,诊断干燥综合征可能具有挑战性。目前,小唾液腺活检被认为是诊断干燥综合征的决定性检查。已经描述了多种手术技术,目标是从下唇获取小唾液腺活检组织。由于出血,识别小唾液腺通常很困难。小唾液腺活检的一种常见并发症是医源性感觉神经损伤导致的唇部感觉异常。

目的

描述一种在局部麻醉下使用睑板腺囊肿眼科夹在无血手术视野中进行小唾液腺活检的技术,并报告我们的临床结果。

方法

对2017年7月至2018年4月期间使用睑板腺囊肿眼科夹进行小唾液腺活检的患者进行了一项前瞻性研究。

结果

该研究纳入了23例患者。组织病理学报告对所有患者均明确鉴定出小唾液腺。在9例病例中,组织学结果显示干燥综合征呈阳性。术后未报告唇部感觉异常并发症。

结论

该技术具有更高的成功率,确保获取足够的合适腺体用于组织病理学分析,并将与传统技术相关的并发症降至最低。

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