The term Ranula is a Latin word meaning frog. It refers to a bluish translucent cystic lesion in the floor of the mouth resembling the underbelly of a frog. Ranulas can be true cysts occurring due to ductal obstruction of the sublingual gland or a minor salivary gland or a pseudocyst as a result of ductal injury leading to extravasation and accumulation of saliva in the surrounding tissues. Clinically ranulas present as intraoral or plunging ranulas. The prevalence of ranula is 0.2% per 1000 patients Ranulas account for 6% of all salivary gland cysts. Ranulas are more common in children and young adults. However the plunging type occurs most commonly in the later third decade. The diagnosis of plunging ranula is based on a combined clinical,radiographic imaging and histologic findings. The treatment of ranulas have always been controversial.The treatment modalities range from simple marsupialisation to excision of the pseudocyst along with sublingual or submandibular gland excision.The purpose of this paper is to present a rare case of plunging ranula and to highlight the importance of considering plunging ranula in the differential diagnosis of lesions of the neck. Key words:Plunging Ranula,mucus, submandibular gland, transcervical approach.

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Introduction: Ankylosis is a physically and psychologically distressing condition to a patient. The aim of this study was to evaluate the efficiency of custom-made temporomandibular joint (TMJ) prosthesis (fossa-condyle component) in patients with unilateral ankylosis in restoring the form and functions of the TMJ. Materials and Methods: This retrospective study was conducted in ten patients with unilateral TMJ ankylosis who had undergone TMJ reconstruction with custom-made TMJ prosthesis. Clinical parameters assessed were maximal mouth opening, lateral movements, improvement of the pain levels, and dietary efficiency of the patient. The data were analyzed using SPSS version 20 (IBM Corporation, SPSS Inc.; Chicago, IL, USA). Results: The mean preoperative mouth opening was 5.70 ± 3.62 mm. After gap arthroplasty, it was 32.50 ± 3.31 mm. The postoperative mouth opening after the reconstruction of TMJ using alloplastic joint prosthesis was 34.90 ± 2.69 mm, and after a mean follow-up period of 4 years, the mean postoperative mouth opening was 34.60 ± 2.50 mm. The mean preoperative movement toward the right and left side was 0.9 ± 1.2 mm and 1.3 ± 1.25 mm, respectively. The mean right and left lateral movements of the TMJ after reconstruction were 3.5 ± 0.97 mm and 3.70 ± 1.06 mm, respectively. There was decrease in deviation of the unaffected jaw during mouth opening and closure. Functional occlusion was maintained postoperatively. There was no appreciable change in the visual analog pain scales. The dietary efficiency improved from a scale of 10 (liquids) to a scale of 0 (no restriction to diet) in eight patients and 1 in two patients. The dietary score improved significantly after alloplastic reconstruction ( P = 0.000). No evidence of facial nerve paralysis or foreign body reactions was noted in the patients during the follow-up period. Radiographic assessment revealed good positioning and adaptation of the fossa component and the condylar ramal component both postoperatively and after a mean 4-year follow-up period. There was no evidence of screw loosening or prosthesis breakage during the follow-up period. Discussion and Conclusion: The custom-made TMJ-total joint replacement (TJR) devices provide stable, improved long-term results, thereby increasing the quality of life of the patient. The custom-made alloplastic TMJ-TJR prosthesis proves to be the optimal surgical procedure to reconstruct the TMJ in comparison to the autogenous grafts (to avoid complications) in severe degenerated and ankylosed joints. However, long-term clinical and radiological studies on a larger sample size are imperative to establish the versatility of this procedure.

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A 30-year-old female patient reported to the Department of Oral Medicine and Radiology with a chief complaint of swelling below the left eye for one year and pain associated with swelling for past one and a half months. The patient gave history of the swelling slowly increasing to the present size. The patient also gave history of trauma at the same region one and a half year back with no history of visual complaints. On extraoral examination, on inspection, marked facial asymmetry was present with a solitary, localized swelling of size 2×2 cm at superior aspect of the left zygoma with ill defined borders. Skin over the swelling was normal. The swelling was bony hard, fixed, moderately tender and non compressible on palpation. The patient was having normal vision. Correlating the history and clinical findings, the case was provisionally diagnosed as osteoma. The patient was subjected to radiological investigations. Paranasal Sinus (PNS) view revealed a localized radiopacity involving lower border of the left orbit and the left zygoma with distinct border. Maxillary sinus appeared normal [ [