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Int Poster J Dent Oral Med 14 (2012), No. 3     15. Sep. 2012

Int Poster J Dent Oral Med 2012, Vol 14 No 3, Poster 609

Recurrence and complications of ranula

A series of 35 cases

Language: English
 

Authors:
Dr. Eva Lakiere, Prof. Serge Schepers, Dr. Luc Vrielinck,
St. John's Hospital, Department of Oral and Maxillofacial Surgery, Genk, Belgium
Prof Ivo Lambrichts, Prof Constantinus Politis,
Hasselt University, Faculty of Medicine, Diepenbeek, Belgium

Date/Event/Venue:
19/03/2012
Spring Meeting, OMFS Belgium
Dolce, La Hulpe
 

Introduction

Definition
• Most ranulas are pseudocysts, originating from ductal injury with subsequent extravasation and accumulation of saliva in the surrounding tissue.
• Sometimes it can be a true cyst with epithelial lining, arising from ductal obstruction.

Clinical presentation
• Oral ranula
 - Blue translucent swelling in the floor of the mouth
• Plunging ranula
 - Cervical swelling
 - Herniates through or at posterior border of the m. mylohyoideus.

 
Fig. 1: Clinical presentation
 
 

Management

Management of the ranula is controversial. There are several different options, each with advantages and disadvantages.

Treatment options
• Aspiration
• Sclerotherapy
• Carbon dioxide laser
• Surgery
 - Marsupialization
 - Ranula excision
 - Sublingual gland + ranula excision
 - Sublingual gland + ranula evacuation

Objectives
Recurrence and complications of ranula treatment in 35 patients.
 

Material and Methods

Retrospective patient file analysis of treated cases between 1993 and 2010.

Fig. 2: Peroperative image
 
Fig. 3: Resectionspecimen

Results

• 35 patients
• 1993-2010
• Age:
 - Mean: 19
 - Range: 4 - 64
• Male-female ratio: 2 to 3

Treatment Number recurrence Other complications
Expectatio 2 0% 0%
Marsupialization 6 50% 50%
Infection (1), plunging ranula (1), togue hypesthesia (1)
Excision ranula 18 28% 6%
cicatrization of Wharton's duct: excision of gl. submandibularis (1)
Excision ranula and gl. sublingualis 7 0% 14%
postoperative bleeding (1)
Excision gl. submandibularis 1 100% 0%
Referral 1    
Tab. 1: Treatment of Ranula

Conclusions

Excision of the ipsilateral sublingual gland with ranula excision (true cyst) or with evacuation of the ranula (pseudocyst) is first choice treatment for oral and plunging ranula
• Marsupialization only in infants or patients in poor general condition
• No additional excision of submandibular gland
 - No causal relationship between submandibular gland and ranula
 - Higher risk of injury of ramus marginalis and hypoglossal nerve with transcervical approach
 

This Poster was submitted by Dr Eva Lakiere.
 

Correspondence address:
Dr Eva Lakiere
St. John's Hospital, Oral and Maxillofacial Surgery
Schiepse Bos 6
3600 Genk
Belgium