The importance of sublingual gland removal in treatment of ranulas: A large retrospective study

Than, Jeffrey K.; Rosenberg, Tara L.; Anand, Grace Shebha; Sitton, Matthew

doi:10.1016/j.amjoto.2020.102418

Cited by 9 publications

(10 citation statements)

References 7 publications

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“…The simple ranula is present within the sublingual space, whereas the plunging ranula extends beyond the mylohyoid muscle to the submandibular space and adjacent structures in the neck, as in our present case (Fig. 1b) [8,23,24].…”

Section: Discussionsupporting

confidence: 65%

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Juvenile primary Sjögren’s syndrome with ranula: is ranula a clinical sign that leads to early detection of Sjögren’s syndrome?

et al. 2020

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Juvenile primary Sjögren’s syndrome (pSS) is rare. Although recurrent parotitis is reported to be the most common symptom of juvenile pSS, the clinical symptoms and features of the syndrome are not well understood and are poorly defined. Here we report a rare case of juvenile pSS in a patient with plunging ranula. The patient had no symptoms other than swelling of the oral floor and had no symptoms of parotitis. Magnetic resonance imaging (MRI) revealed the diagnosis of plunging ranula. In addition, the findings of the bilateral parotid glands on MRI and subsequent ultrasonography (US) strongly suggested SS. On the basis of these imaging findings and laboratory data, a pediatric rheumatologist confirmed the diagnosis of juvenile pSS. The ranula may be one clinical sign of SS. However, this association remains generally unknown. Hypothesizing that SS might cause ranula development, we retrospectively investigated cases of patients with ranula who underwent MRI at our hospital. We found that many of these patients (> 20%) had characteristic findings strongly suggestive of SS. This result suggests that SS-induced changes in the sublingual glands are one cause of ranula formation. We think that ranula is a sign of early-stage SS. Therefore, patients with ranulae, whether adults or children, should undergo careful assessment of not only the sublingual glands but also the parotid and submandibular glands with MRI and/or US to investigate possible SS. This assessment may lead to early detection of SS.

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Section: Discussionsupporting

confidence: 65%

“…However, Than et al reported many pediatric ranula cases. According to that report, simple ranulae are more common and occur at a younger average age than plunging ranulae [24].…”

Section: Discussionmentioning

confidence: 99%

Juvenile primary Sjögren’s syndrome with ranula: is ranula a clinical sign that leads to early detection of Sjögren’s syndrome?

et al. 2020

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“…3) In addition, plunging ranula and intraoral ranula showed different clinical courses and they required different approach for diagnosis and treatment. 6,8,13,15) However, many previous studies did not classify the subtype of ranula. 13,[15][16][17] Therefore, it has been necessary to perform a large-scaled study confined to plunging ranula, and we focused on patients with plunging ranula to have homogeneous enrollment of subjects and obtain reliable results.…”

Section: Discussionmentioning

confidence: 99%

“…6,8,13,15) However, many previous studies did not classify the subtype of ranula. 13,[15][16][17] Therefore, it has been necessary to perform a large-scaled study confined to plunging ranula, and we focused on patients with plunging ranula to have homogeneous enrollment of subjects and obtain reliable results.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies enrolled the subjects with heterogenous types of ranula and they did not focus on plunging ranula or intraoral ranula which could affect to treatment methods and outcomes. [13][14][15] Furthermore, they had practiced inconsistent procedures such as sublingual gland excision, ranula excision or extirpation. In addition, they did not report about clinical course and salvage treatment after failure of initial treatment.…”

Section: Introductionmentioning

confidence: 99%

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Sublingual Gland Excision and Sclerotherapy for Plunging Ranula and Management of Recurrence

Kim¹,

Yi²,

Park³

et al. 2022

Korean J Otorhinolaryngol-Head Neck Surg

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Background and Objectives For plunging ranula, excision of the sublingual gland has been the major treatment option, with sclerotherapy being widely used as minimal invasive treatment. We compared the outcomes of these two methods as an initial treatment for ranula and investigated the outcomes of salvage procedure in recurred patients.Subjects and Method Patients were classified into the excision group (n=35) and the sclerotherapy group (n=39) according to the type of their initial treatment. The outcomes of the initial and salvage treatment were determined as recurrence or non-recurrence at 3 months after treatment, and statistically compared between the excision and the sclerotherapy groups.Results Recurrence in the sclerothearpy group (n=20, 51.3%) showed a significantly higher rate (p<0.001) than in the excision group (n=3, 8.6%). Recurring patients who received treatment different from the initial treatment (n=7) were cured, while those who had same procedure as the initial treatment (n=11) showed recurrence of 72.7% (n=8). There was no procedure related complication among the patients.Conclusion Sublingual gland excision was more effective than ethanol sclerotherapy for the treatment of plunging ranula. In addition, sublingual gland excision was effective even after the failure of ethanol sclerotherapy.

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Amylase as a Diagnostic Tool for Plunging Ranula: Clinical Series and Description of the Technique

et al. 2022

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Objectives This study describes a technique of measurement for neck cyst amylase content and reviews the experience of a tertiary referral center for cases of suspected plunging ranula. Methods A retrospective study was performed at the Manukau Surgical Center in Auckland, New Zealand. Patients with a possible diagnosis of plunging ranula based on clinical presentation and diagnostic aspiration of the cyst contents were included. Demographic data, imaging and laboratory findings were collected, along with findings from surgery and histology. The technique for measuring the amylase of the aspirated cyst contents was also carefully recorded. Results The 37 cases of confirmed plunging ranula included in this study had a submandibular cystic swelling that was aspirated. Imaging features consistent with a plunging ranula were seen in 89% of the study group. All cases had detectable levels of amylase of ≥3 U/L in the ranula contents. There was large variability (range: 5–560 U/L) in the concentration of amylase, with 70% of the cases demonstrating an amylase concentration below 200 U/L. Aspirates were typically described as viscous (87.5%) and yellow or straw‐colored. Conclusion The combination of clinical presentation, imaging and the presence of amylase in the cyst contents is diagnostic for plunging ranula. Level of Evidence 4 Laryngoscope, 133:535–538, 2023

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The importance of sublingual gland removal in treatment of ranulas: A large retrospective study

Cited by 9 publications

References 7 publications

Juvenile primary Sjögren’s syndrome with ranula: is ranula a clinical sign that leads to early detection of Sjögren’s syndrome?

Juvenile primary Sjögren’s syndrome with ranula: is ranula a clinical sign that leads to early detection of Sjögren’s syndrome?

Sublingual Gland Excision and Sclerotherapy for Plunging Ranula and Management of Recurrence

Amylase as a Diagnostic Tool for Plunging Ranula: Clinical Series and Description of the Technique

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