| This is a case report of a 20-year-old man with ranula, the size of an orange, in the floor of the mouth causing mandibular prognathism with fan-shaped mandibular teeth anterior to the premolars. The tumor was extirpated. The pathogenesis, differential diagnosis and treatment of ranulas are discussed. ( info) |
| Mucoceles originating from the submandibular gland are extremely rare. A review of the English literature resulted in identification of only 5 such cases. We have diagnosed and treated 2 submandibular mucoceles. Both lesions were removed in continuity with the submandibular and sublingual glands. No complications and no recurrences have occurred to date. The diagnosis of these lesions is complicated because of the lack of specific clinical diagnostic criteria and the similarity between submandibular mucoceles and plunging or cervical ranulas. Computerized tomography and specifically the presence of a so-called "tail" sign is pathognomonic for plunging ranula. This sign is absent in mucoceles originating in the submandibular glands. The treatment strategies vary as well. A diagnostic algorithm and a surgical rationale for treatment of submandibular mucoceles are presented. ( info) |
3/53. Nonsurgical treatment of a sublingual ranula in a ten-month-old baby. A clinical case of nonsurgical treatment of a sublingual ranula in a ten-month-old baby is presented. ( info) |
4/53. Salivary duct cyst: its frequency in a certain Japanese population group (Tohoku districts), with special reference to adenomatous proliferation of the epithelial lining. It is reported in the European and American literature that salivary duct cysts constitute about 10% of all cysts of the salivary glands, although they appear to be rare in japan. Between 1975 and 1999, only 3 (0.5%) of 586 salivary gland cysts were diagnosed as salivary duct cysts at the Division of Clinical pathology, Iwate Medical University Hospital. Histologically, two cases appeared as a unilocular lesion lined by double- and multi-layered epithelium. The other case showed marked, intraluminar and intramural adenomatous proliferation of the epithelial lining, suggesting that the lesion was a benign tumor. A review of the literature yielded only two cases of tumors arising in pre-existing salivary duct cysts. ( info) |
5/53. Plunging ranula as a complication of intraoral removal of a submandibular sialolith. Mucous cysts in the submandibular region--so-called 'plunging' ranula--are relatively uncommon. We report a case of a plunging ranula that complicated excision of an intraductal sialolith of the submandibular gland. ( info) |
6/53. Treating oral ranula: another case against blanket removal of the sublingual gland. There are a number of occasions when ranula-like lesions of the oral floor can develop that do not originate from the sublingual gland, or that arise from the gland with no tendency towards recurrence. The author advises that the unconditional removal of the sublingual gland should not be the standard treatment for all ranulas, and present four case reports to illustrate these and describe how they should be treated. All the patients were treated successfully with conservative management and retained normal functioning sublingual glands. Except for the management of plunging ranulas, caution and a close examination of the origin of the lesion are prudent before considering excision of sublingual glands for all ranula-like lesions. ( info) |
7/53. Recurrent congenital bilateral ranula: a case report. A case of congenital bilateral ranula in a one-week-old male baby is reported. At presentation the cyst measured 3.5 x 2.5 cm but did not interfere with feeding. Initial marsupialisation resulted in recurrence of the cyst. It was subsequently re-excised completely together with the associated sublingual salivary gland. The cyst has not recurred six months after treatment. The usually large size of the cyst and its bilateral presentation makes this an interesting case. ( info) |
8/53. Local injection of OK-432 in the treatment of ranula: a case report. We treated a 57-year-old woman for ranula. After aspirating the cyst's contents, we administered 0.1 KE/ml of OK-432 via local injection. One month later, the cyst had still persisted, so we repeated the procedure. After 2 weeks, the ranula began to shrink markedly, and at 4 weeks it had almost disappeared. No recurrence of the ranula was observed during the subsequent 1 year of follow-up. Following each injection, the patient developed transient fever and local swelling but no serious complications. Our experience suggests that OK-432 injection is an effective treatment for ranula. However, because this treatment causes the cyst to collapse rather than disappear completely, patients should be regularly monitored over the long term. ( info) |
9/53. A rare case of an extensive plunging ranula: discussion of imaging, diagnosis, and management. A plunging ranula is a mucous extravasation cyst appearing as a swelling in the submental and submandibular regions. We describe a rare case of massive plunging ranula involving multiple tissue spaces. A magnetic resonance imaging scan revealed the true extent of the lesion and its relationship to the surrounding structures. Other imaging techniques and diagnostic tests are discussed. The unusual course of events following surgical excision of the offending sublingual gland is presented. The relevant literature is reviewed. ( info) |
10/53. Management of pediatric ranula. OBJECTIVE: Many surgical techniques to manage ranulas have been described in the literature. These techniques include excision of the cyst with or without excision of the ipsilateral sublingual gland, marsupialization, cryosurgery, and CO(2) laser excision. Few studies have described the approach toward management in pediatric patients. methods: Six patients were treated for intraoral ranulas. Two patients had spontaneous resolution of their lesions. Four patients required dissection of the submandibular duct and lingual nerve to completely excise an oral cavity ranula and an ipsilateral sublingual gland. RESULTS: There were no recurrent lesions. One patient developed a lingual nerve injury but no numbness. The 2 patients with spontaneous resolution did not develop a subsequent lesion. CONCLUSION: Optimal management of pediatric oral cavity ranulas may include observation for 5 months for spontaneous resolution. If the lesion does not resolve or recurs repeatedly, surgical treatment is recommended. Submandibular duct dissection with relocation appears to enhance exposure to the floor of mouth. The pseudocyst and entire sublingual gland should be removed. Identification of the lingual nerve is necessary to accomplish this goal. ( info) |