11/53. Congenital ranula. A report of two cases. We report 2 unusual cases of congenital ranula in male Nigerian infants. Clinical examination could not discern the orifice of the submandibular duct on the affected sides, while a lower occlusal radiograph revealed no obvious calculi. Diagnosis was mainly by clinical presentation. The paper highlights possible aetiopathogenesis, clinical aspects and diagnostic features. Emphasis is laid on the need for careful evaluation of oral ranulas in order to discern their origin and provide appropriate treatment. ( info) |
12/53. Plunging ranula: a report of two cases. Plunging ranula, a rare differential diagnosis of cervicofacial masses is presented in two Nigerian patients. The authors highlight the pathophysiology and treatment methods of this condition. It is suggested that clinicians be aware of the various modes of presentation and natural history of the disease to facilitate prompt diagnosis and appropriate treatment. ( info) |
13/53. Recurrent plunging ranula treated with OK-432. A 36-year-old man was admitted who had a 2-month history of swelling of the right submandibular area and the right side of the mouth floor. He had undergone operations for right plunging ranula with a lesion on the floor of the mouth twice 7 years ago. Under fluoroscopic guidance, the contents of the cyst were aspirated as much as possible and injected with the same amount of OK-432 solution (picibanil 0.1 mg; 10 ml) twice with 3-week intervals. Examination after 6 weeks showed that the cystic mass seen before therapy had disappeared completely, and no recurrence was encountered after 1 year. We here report a case in which a successful sclerotherapy with OK-432 for recurrent plunging ranula after surgery was performed. ( info) |
14/53. Treatment of ranula--excision of the sublingual gland versus marsupialization. The purpose of this work is to estimate optimum surgical treatment of ranula according to the type of the lesion. Nine patients with ranula surgically treated between 1989 and 2000 were investigated retrospectively. Six patients had sublingual type ranula and three had submandibular type. In five cases including recurrence cases, the sublingual gland was excised. Marsupialization was performed for four cases, which were superficial, protruded and within 2 cm of diameter. In all cases, histopathological diagnoses were pseudocysts without epithelial lining and there was no recurrence. Almost all ranulas are pseudocysts from the sublingual gland, therefore excision of the sublingual gland is considered to be a reasonable and radical treatment. For the small sublingual type, which is superficial, protruding and smaller than 2 cm in diameter, marsupialization is also a useful modification of surgical treatment of ranula. ( info) |
The plunging ranula is a mucous extravasation cyst of the sublingual gland. It is slightly more common in females, shows no side preference, and is more prevalent in the second and third decades of life. It typically manifests as a painless, nonmobile swelling in the neck and in four of five cases is associated with an intraoral ranula or swelling. If there is no history of an oral ranula the clinical diagnosis is difficult, and it may be left to the reporting pathologist to give the correct diagnosis. The histologic appearance is characteristically of a cyst, devoid of epithelium or endothelium, with a vascular fibro-connective tissue wall containing some chronic inflammatory cells and macrophages stuffed with mucin. The correct diagnosis is essential for the most effective treatment, which is excision of the sublingual gland. ( info) |
16/53. Marsupialization for treatment of oral ranula: a second look at the procedure. Simple marsupialization to manage oral ranula has fallen into disfavor because of excessive failures and the high incidence of iatrogenically caused cervical ranula that may follow this procedure. With the simple addition of packing the entire pseudocystic cavity with gauze after its unroofing, the rate of recurrence is minimized. It is recommended that oral ranula be treated initially by marsupialization with packing and, if recurrence occurs, then the offending sublingual gland should be excised. ( info) |
A fetal sublingual cystic lesion was diagnosed by routine prenatal ultrasonography at 21 weeks of gestation and followed up until term in a tertiary care center. Fetal growth was normal as was the amniotic fluid volume. Ex utero intrapartum treatment was performed and the cyst was aspirated to allow breathing and swallowing during planned cesarean section. The cyst was totally excised when the newborn was 27 days of age and histological examination revealed a mucous cyst of the mouth floor. ( info) |
18/53. Treatment of a plunging ranula with fenestration and continuous pressure. We present a new method of fenestration and continuous pressure as a simple, effective and uninvasive procedure for the treatment of plunging ranulas. We have recently used in four female patients, aged 10-29 years old. After treatment, the patients remained symptom-free and assessment by magnetic resonance imaging (MRI) showed regression of the ranula in all cases. The procedure resulted in satisfactory healing and we advocate it as a simple and effective treatment that is better for patients than conventional treatment. ( info) |
19/53. Lingual tumors in infants: a case report and review of the literature. Tumors of the tongue and the base of mouth are seen rarely in children. The incidence of the ones that are large enough to fill the oral cavity is especially low. If not recognized and treated, tongue tumors may obstruct the upper aero-digestive tract and be fatal. A case of a huge lingual cystic tumor mimicking ranula, and obstructing the upper aero-digestive tract, which was diagnosed antenatal and treated during and after the delivery, is presented together with a review of the literature. ( info) |
A case is reported of a papillary cystadenocarcinoma of the sublingual gland which presented as a ranula. This is both rare in site and mode of presentation. ( info) |