KBB-Forum 2024 , Cilt 23, Sayı 3

AN EVALUATION OF THE NEED FOR MINOR SALIVA GLAND BIOPSY AND THE CLINICAL CORRELATION IN THE DIAGNOSIS OF PRIMARY SJOGREN SYNDROME

Gökhan TOPTAŞ 1, MD; Osman CERLET 2, MD; Şevket AKSOY 1, MD; Mehmet Murat GÜNAY 1, MD; Sümeyra DOLUOĞLU 1, MD; Ömer BAYIR 1, MD; Güleser SAYLAM 3, MD;
1Ankara Etlik Şehir Hastanesi, Kulak Burun Boğaz ve Baş Boyun Kliniği, Ankara, Turkey
2Ankara Bilkent Şehir Hastanesi, Kulak Burun Boğaz ve Baş Boyun Kliniği, Ankara, Turkey
3Lokman Hekim Üniversitesi Tıp Fakültesi, Kulak Burun Boğaz ve Baş Boyun Kliniği, Ankara, Turkey Aim: The aim of this study was to compare the rate of diagnostic contribution of the results of minor saliva gland biopsy taken for diagnosis of Sjögren syndrome (SS) and patient clinical findings and autoantibody test results.

Material and Methods: This retrospective study included patients who underwent serological tests with an initial diagnosis of SS and were referred to the Ear, Nose, and Throat Clinic for minor saliva gland biopsy. The demographic data, complaints, clinical findings, autoantibody test results and biopsy results of the patients were evaluated. The Chisholm-Mason classification was used to show lymphocyte infiltration in the saliva gland biopsy specimens. As all the cases were simple with a low complication risk, minor saliva gland biopsy was performed. Patients with secondary SS and those aged <18 years were excluded from the study.

Results: Saliva gland biopsy was performed on a total of 67 patients, comprising 58 (86.5%) females and 9 (13.5%) males with a mean age of 48.2 years (range, 21-78 years). In 3 cases the biopsies were unsuccessful, and of the 64 biopsies with successful sampling, 19 (29.6%) were reported as consistent with primary SS. The complaints of the patients were dry mouth (85.9%), dry eyes (73.4%), arthralgia (23.4%), and pain and swelling in the saliva gland (17.1%). Of the 19 (29.6%) patients with pathology reported as consistent with primary SS, positivity in at least one of the autoantibody tests (ANA, RF, SS-A, SS-B) was determined in 15 (23.4%) patients. The diagnosis of SS was made with saliva gland biopsy in 4 (6.2%) patients determined with negative autoantibody tests. Temporary marginal nerve paresis due to local anaesthesia was observed in only one patient, and no permanent complications developed in any patient.

Conclusion: Minor saliva gland biopsy is a method that can be safely and easily applied under office conditions. In the diagnosis of primary Sjögren syndrome, it is recommended that the diagnosis is confirmed with minor saliva gland biopsy when clinical findings are present. Keywords : Chisholm-Mason classification, Minör saliva gland biopsy, minor saliva gland biopsy, Sjögren Syndrome