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Surgery

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Salivary Gland

Question
55 out of 80
 

Which of the following best represents 'ranula'?



A A type of epulis

B A thyroglossal cyst

C Cystic swelling in the floor of mouth

D Forked uvula

Ans. C Cystic swelling in the floor of mouth (Ref: Bailey 25/e p754)

Ranula

• A cystic swelling in the floor of mouth that resembles a frog belly".

• Term ranula should only be applied to a mucous extravasation cyst that arises from the sublingual gland

Etiology

• Commonly the lesion is induced by local trauma and duct rupture, followed by mucin spillage into the surrounding soft tissues (mucous extravasation phenomenon)

• Uncommonly, it is due to obstruction, probably caused by mucous plug or a sialolith

Histopathology

• Mucin accumulation surrounded by granulation and fibrous tissue (mucous extravasation phenomenon)

• A cyst cavity, filled with mucin and lining by the ductal epithelium (mucous retention cyst)

• Chronic inflammation of the cyst wall is present. Infiltration by numerous neutrophils, histiocytes, and plasma cells are common.

Clinical Features

• Exclusively present on the floor of mouth

• Usually unilateral, lateral to midline

• Smooth, dome shape, fluctuating and painless swelling

• The color is usually bluish, but deep lesions may have a normal color.

• The size varies from a few to several centimeters in diameter. Very large lesions which may occupy the floor of mouth can also occur.

Diagnosis

• Diagnosis is usually made clinically,

Treatment

• Surgical removal or marsupialization,

Plunging Ranula

• Intraoral ranula with cervical prolongation,

• Plunging ranula extends from the floor of the mouth below the mylohyoid into the neck.

• This is nearly always an extravasation pseudocyst.

• Presents as soft painless, ballottable mass with cross fluctuation.

Salivary Gland Flashcard List

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