Surgical treatment of plunging ranula: Report of three cases and review of literature

Çiriş

Journal of Craniofacial Surgery

et al. 2021

Ranula is a retention cyst that develops from the salivary glands. It has 2 subtypes, oral and diving. There are differences in the clinical features of ranula subtypes. In particular, diving ranula is more prone to extend in the neck spaces than oral ranula. The enlargement of the diving ranula is generally downward in the neck. If the opposite occurs, we may encounter very interesting and difficult cases. Diving ranula should be kept in mind in the differential diagnosis of cystic neck masses in the pediatric age group and its treatment should be done surgically.A 15-year-old girl admitted to our clinic with the complaint of swelling in the floor of the mouth and neck. In physical examination of the patient, a mass with cystic content was observed adjacent to the left Wharton canal. In addition, a 4 Â 3 cm, soft, fluctuant, nonfixed, painless mass was palpated in the left submandibular area. Magnetic resonance imaging revealed that the neck mass was a diving ranula extending from the parapharyngeal space to the skull base. In the surgery, submandibular and sublingual salivary glands were removed together with the diving ranula. We observed no complications in the postoperative period.Magnetic resonance imaging should be used to confirm the diagnosis of diving ranula. In the treatment of diving ranula, excision of the ranula alone is not enough surgically. We also recommend excision of the submandibular and/or sublingual salivary glands associated with ranula to reduce the recurrence rate.

Section: Discussionmentioning

confidence: 99%

A Giant Diving Ranula Extending to the Skull Base in Pediatric Age

Çiriş

Journal of Craniofacial Surgery

et al. 2021

Archives Oral Maxillofac Surg

“…Informed consent was obtained from the patient. used for two pathogenetically distinct entities which are mucus extravasation cysts (MECs) and mucous retention phenomena (MRP) [2]. A MEC results when mucus leaks out of a traumatized salivary gland into the surrounding connective tissue.…”

Section: Ethical Approvalmentioning

confidence: 99%

“…However, less commonly, it may occur in the floor of the mouth where it may be referred to as a ranula and may attain huge dimensions [1]. A ranula is referred to as "oral" or "superficial" if it is limited to the oral cavity above the mylohyoid, and "deep diving", "plunging" or "cervical" if it lies below the mylohyoid [2][3][4]. Plunging ranulas are rarer than oral ranulas [4].…”

Section: Introductionmentioning

confidence: 99%

Giant Plunging Ranula Presenting As an Emergency: A Case Report

Adeosun¹,

Chabiya²,

Ifeoma³

2021

Plunging ranulas are pseudocysts which originate from major salivary glands and present as neck swellings with possible life-threatening complications. We present an unusual case of a plunging ranula which presented as an emergency. The patient presented at our clinic with a 4-year history of an asymptomatic recurrent neck swelling which we diagnosed as a ranula. She was clinically stable and we planned for elective surgery in five days. However, three days after clinic review, she presented at the emergency room on account of dyspnoea and dysphagia. She was hospitalized and the surgery was carried out as an emergency, life-saving procedure. This case highlights the importance of anticipating life-threatening complications in seemingly clinically stable cases of plunging ranulas.

“…Na tomografia computadorizada ou no exame de ressonância magnética, o "sinal em cauda" pode ser observado, representando a extensão da lesão do espaço sublingual até o submandibular. Esse achado imaginológico pode ajudar no diagnóstico diferencial (Lyly, et al, 2017;Kolomvos, et al, 2019).…”

Section: Introductionunclassified

Exérese da glândula sublingual para o tratamento de rânula mergulhante

Gomes

Coli²,

Pereira³

et al. 2023

RSD

As rânulas mergulhantes são pseudocistos que se originam na glândula salivar sublingual e distendem-se até o espaço submandibular e, em seguida, em espaços cervicais mais profundos. Diversas abordagens têm sido descritas na literatura referente ao tratamento da rânula mergulhante, dentre elas, métodos cirúrgicos e não cirúrgicos. Por esse viés, o presente estudo tem como objetivo principal fornecer argumentos baseados em evidencias clínicas e científicas de que a excisão intraoral completa da glândula sublingual é a abordagem mais racional para o tratamento da rânula mergulhante. O artigo foi realizado por meio de uma revisão de literatura sistemática, o qual contou com artigos científicos indexados nas bases de dados como Google Acadêmico, SciELO e PubMed. As etapas metodológicas trataram-se da definição e aplicação dos critérios de inclusão e exclusão, levantamento bibliográfico segundo as bases de dados mencionadas e síntese na escrita da revisão. Dos 145 resultados obtidos inicialmente, o presente trabalho contou com 27 artigos para sua construção, no qual, relatos adquiridos a partir dos estudos selecionados declaram que a remoção da glândula sublingual é a melhor escolha no manejo cirúrgico da rânula mergulhante ao invés da excisão do cisto, uma vez que a glândula se apresenta como a fonte de formação desse muco cujo acúmulo está relacionado ao processo patológico. Destarte, essa abordagem de tratamento depende da experiência do cirurgião, mediante ao conhecimento sobre as alterações patológicas das glândulas salivares, suas características clínicas e o envolvimento das estruturas adjacentes, levando em consideração a extensão e posição da lesão.