J Korean Cleft Palate-Craniofac Assoc.  2010 Oct;11(2):111-115.

Surgical Treatment of a Plunging Ranula using the Intraoral and Submandibular Approach

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea. sceun@snubh.org

Abstract

PURPOSE
A plunging ranula is relatively uncommon and represents a mucus escape reaction occurring from a disruption of the sublingual salivary gland. It is a common condition found in young adults, even though the reported age range is 2 - 61 years. We report our experience of a complete excision of a plunging ranula via the intraoral and submandibular approach.
METHODS
A 23-year-old man had a large protruding mass in the right submandibular area. Initially, the protruding mass appeared bilaterally but the left side disappeared spontaneously. The MRI findings revealed a homogenous fluid attenuation mass in the submandibular space, suggesting a ranula. The sublingual gland was extirpated through the intraoral approach and the ranula excised totally via the submandibular approach.
RESULTS
The patient had an uneventful postoperative course without infection, paralysis and tongue sensory changes, etc. The pathology findings were characteristic of a pseudocyst without a lining epithelium or endothelium but with a vascular fibro-conective tissue wall filled with mucinous fluid. No recurrence was observed on the submandibular area during the 8 month follow-up period.
CONCLUSION
The combined intraoral approach and submandibular approach is an effective and highly recommended method for sublingual gland extirpation and complete excision of a plunging ranula.

Keyword

Ranula; Sublingual gland; Submandibular approach
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