title: Neurological adverse events related to lip biopsy in patients suspicious for Sjögren's syndrome: a systematic review and prevalence meta-analysis.
abstract: OBJECTIVE
  The aim of this study was to compare the prevalence of neurological complications related to lip biopsy for SS diagnosis using conventional vs minimally invasive techniques.
  
  
  METHODS
  We performed a systematic review and prevalence meta-analysis using the search strategy [(salivary gland biopsy OR labial biopsy OR lip biopsy) AND (Sjögren)] in the MEDLINE, EMBASE and Web of Science Conference Proceedings Citation Index databases. Studies were selected if they included original data for minor salivary gland biopsy, sample size, exposure of interest (technique description), number of complications and number of affected patients. The prevalence of total and permanent neurological adverse effects was calculated. Both fixed-effects and random-effects pooled estimates were assessed. Heterogeneity was calculated using an adaptation of the DerSimonian and Laird Q test.
  
  
  RESULTS
  Sixteen articles were selected for the study. In the minimally invasive group (n = 3), the pooled prevalence of total adverse events is almost four times higher than that in the linear incision group (n = 12) (4.73% vs. 1.20%). In contrast, the pooled prevalence of the permanent or potentially permanent neurological adverse events is 8.5 times lower in the minimally invasive technique group than in the studies using linear incisions (0.17% vs. 1.45%).
  
  
  CONCLUSIONS
  With the limitations intrinsic to the potential biases in the studies included in this meta-analysis, we conclude that the minimally invasive lip biopsy technique for SS diagnosis induces fewer permanent neurological complications than conventional approaches with large linear incisions in the lower lip.
authors.affiliation: Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Department of Mathematics, Faculty of Informatics, University of A Coruña and Department of Preventive Medicine, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Varela Centelles
authors.affiliation: Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Department of Mathematics, Faculty of Informatics, University of A Coruña and Department of Preventive Medicine, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
authors.forename: Mariña
authors.initials: M
authors.lastname: Sánchez-Sánchez
authors.affiliation: Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Department of Mathematics, Faculty of Informatics, University of A Coruña and Department of Preventive Medicine, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
authors.forename: Julián
authors.initials: J
authors.lastname: Costa-Bouzas
authors.affiliation: Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Department of Mathematics, Faculty of Informatics, University of A Coruña and Department of Preventive Medicine, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Seoane-Romero
authors.affiliation: Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Department of Mathematics, Faculty of Informatics, University of A Coruña and Department of Preventive Medicine, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain. juanmanuel.seoane@usc.es.
authors.forename: Juan
authors.initials: J
authors.lastname: Seoane
authors.affiliation: Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Department of Mathematics, Faculty of Informatics, University of A Coruña and Department of Preventive Medicine, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
authors.forename: Bahi
authors.initials: B
authors.lastname: Takkouche
mesh_terms: D001706:Biopsy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D006987:Hypesthesia / Q000453:epidemiology*; D008046:Lip / Q000473:pathology*; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D015995:Prevalence; D012470:Salivary Glands, Minor / Q000473:pathology; D012859:Sjogren's Syndrome / Q000175:diagnosis*
keywords: Sjögren’s syndrome; adverse events; complications; diagnosis; lip biopsy; minor salivary gland; neural damage