Retrospective analysis of ranula patients managed with surgical treatment

Year 2020, , 261 - 264, 25.04.2020

Fazilet Altın , Yalçın Alimoğlu

https://doi.org/10.32448/entupdates.688446

Abstract

Objective: We aimed to examine patient characteristics, recurrence rate and efficacy of treatment methods in patients who underwent surgery with the diagnosis of ranula in our department retrospectively. The subject is discussed in the light of current literature.
Methods: Twenty-seven patients with ranula managed surgically between 2008 and 2018 were included in this study. The indications, age and sex distribution, surgical pathology reports, surgical methods, complications encountered and recurrence rates were examined retrospectively.
Results: The mean age was 27.48±18.66 years. There were 8 (29.6%) male and 19 (70.4%) female cases. The mean size of the ranula was 3.07±0.35 cm. When the symptoms were evaluated, 23 (85.2%) of the patients had a swelling in the floor of the mouth, 3 (11.1%) had a neck swelling and 1 (3.7%) had swelling on the lower surface of the tongue. The treatment method was marsupialization in 11 (40.7%) patients and ranula cyst excision in 16 (59.3%) patients. Four (14.8%) of these patients had a recurrence. The first surgical procedure was marsupialization in 3 (75%) and cyst excision in 1 (25%) of the cases with recurrence. Of the patients with recurrence, 3 subsequently underwent cyst excision and 1 of the patients underwent marsupialization. No complication or additional recurrence was observed in the follow-up of these patients.
Conclusions: Concerning our ten years of experience with the management of ranula, we can conclude that ranula can be treated by both marsupialization and cyst excision with a low risk of recurrence. 

Keywords

Ranula, treatment, surgery

References

• 1. Gossett JD, Smith KS, Sullivan SM, Harsha BC. Sudden sublingual and submandibular swelling. J Oral Maxillofac Surg 1999;57:1353-6.
• 2. Anastassov GE, Haiavy J, Solodnik P, Lee H, Lumerman H. Submandibular gland mucocele: diagnosis and management. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;89:159-63.
• 3. Morton RP. Surgical Management of Ranula Revisited. World J Surg 2018;42:3062-3.
• 4. Chung YS, Cho Y, Kim BH. Comparison of outcomes of treatment for ranula: a proportion meta-analysis. Br J Oral Maxillofac Surg 2019;57:620-6.
• 5. Morton RP, Bartley JR. Simple sublingual ranulas: pathogenesis and management. J Otolaryngol 1995;24:253-4.
• 6. Mizuno A, Yamaguchi K. The plunging ranula. Int J Oral Maxillofac Surg 1993;22:113-5.
• 7. Quick CA, Lowell SH. Ranula and the sublingual salivary glands. Arch Otolaryngol 1977;103:397-400.
• 8. Andiran N, Sarikayalar F, Unal OF, Baydar DE, Ozaydin E. Mucocele of the anterior lingual salivary glands: from extravasation to an alarming mass with a benign course. Int J Pediatr Otorhinolaryngol 2001;61:143-7.
• 9. Zhao YF, Jia Y, Chen XM, Zhang WF. Clinical review of 580 ranulas. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;98:281-7.
• 10. Kokong D, Iduh A, Chukwu I, Mugu J, Nuhu S, Augustine S. Ranula: Current Concept of Pathophysiologic Basis and Surgical Management Options. World J Surg 2017;41:1476-81.
• 11. Harrison JD, Kim A, Al-Ali S, Morton RP. Postmortem investigation of mylohyoid hiatus and hernia: aetiological factors of plunging ranula. Clin Anat 2013;26:693-9.
• 12. de Camargo Moraes P, Bönecker M, Furuse C, Thomaz LA, Teixeira RG, de Araújo VC. Mucocele of the gland of Blandin-Nuhn: histological and clinical findings. Clin Oral Investig 2009;13:351-3.
• 13. Delbem AC, Cunha RF, Vieira AE, Ribeiro LL. Treatment of mucus retention phenomena in children by the micro-marsupialization technique:case reports. Pediatr Dent 2000;22:155-8.
• 14. Zhi K, Wen Y, Ren W, Zhang Y. Management of infant ranula. Int J Pediatr Otorhinolaryngol 2008;72:823-6.
• 15. Morita Y, Sato K, Kawana M, Takahasi S, Ikarashi F. Treatment of ranula--excision of the sublingual gland versus marsupialization. Auris Nasus Larynx 2003;30:311-4.
• 16. Luiz AC, Hiraki KR, Lemos CA Jr, Hirota SK, Migliari DA. Treatment of painful and recurrent oral mucoceles with a high-potency topical corticosteroid: a case report. J Oral Maxillofac Surg 2008;66:1737-9.
• 17. Roh JL, Kim HS. Primary treatment of pediatric plunging ranula with nonsurgical sclerotherapy using OK-432 (Picibanil). Int J Pediatr Otorhinolaryngol 2008;72:1405-10.
• 18. Ohta N, Fukase S, Suzuki Y, Aoyagi M. Treatment of salivary mucocele of the lower lip by OK-432. Auris Nasus Larynx 2011;38:240-3.
• 19. Chow TL1, Chan SW, Lam SH. Ranula successfully treated by botulinum toxin type A: report of 3 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;105:41-2.
• 20. Rezende KM, Moraes Pde C, Oliveira LB, Thomaz LA, Junqueira JL, Bönecker M. Cryosurgery as an effective alternative for treatment of oral lesions in children. Braz Dent J 2014;25:352-6.