J Korean Assoc Oral Maxillofac Surg.  2019 Dec;45(6):357-363. 10.5125/jkaoms.2019.45.6.357.

Case report of the management of the ranula

• Choi MG

• KMID: 2467188
• DOI: http://doi.org/10.5125/jkaoms.2019.45.6.357

Abstract

Ranula is a mucocele caused by extravasation of the sublingual gland on the floor of the mouth. The most common presentation is a cystic mass in the floor of the mouth. A portion of the sublingual gland could herniate through the mylohyoid muscle, and its extravasated mucin can spread along this hiatus into submandibular and submental spaces and cause cervical swelling. This phenomenon is called plunging ranula. A variety of treatments for ranula has been suggested and include aspiration of cystic fluid, sclerotherapy, marsupialization, incision and drainage, ranula excision only, and excision of the sublingual gland with or without ranula. Those various treatments have shown diverse results. Most surgeons agree that removal of the sublingual gland is necessary in oral and plunging ranula. Four patients with ranula were investigated retrospectively, and treatment methods based on literature review were attempted.

Keyword

Ranula; Sublingual gland; Plunging ranula

MeSH Terms

Drainage
Humans
Mouth
Mucins
Mucocele
Ranula*
Retrospective Studies
Sclerotherapy
Sublingual Gland
Surgeons
Mucins

Figure

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  Fig. 1 A. The patient showed left submental swelling. B. On computed tomography, a mutilocuated cystic lesion at the left sublingual and submental space was observed.

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  Fig. 2 Because the cystic wall was fragile, the cyst ruptured. Cystic fluid was suctioned. Only the affected left sublingual gland and attached ruptured cystic component were removed transorally.

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  Fig. 3 A mucus-containing space lined fibrous connective tissue or granulation tissue with various sizes of vascular lumen (H&E staining, ×33).

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  Fig. 4 A. The patient showed submandibular swelling. B. On computed tomography, cystic mass was observed around the right submandibular gland.

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  Fig. 5 Intraoperatively, cystic mass attached to both sublingual and submandibular gland, so both glands were removed.

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  Fig. 6 A. A right mouth floor swelled. B. On computed tomography, cystic mass, sized 3×7 cm2 was observed.

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  Fig. 7 On computed tomography, more increased sized ranula was observed.

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  Fig. 8 Ranula and sublingual gland were removed together.

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  Fig. 9 On computed tomography, a small cystic mass attached to sublingual gland.

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