Plunging ranula: Clinical observations

Abstract

Background The plunging ranula is a relatively uncommon phenomenon which represents a mucus escape reaction occurring from disruption of the sublingual salivary gland. We present a series of 20 patients managed at Green Lane Hospital (Auckland, New Zealand) over a 9‐year period. Methods A retrospective review of 13 patients with this condition was undertaken, and a prospective study was conducted on 7 patients. Information was collected on age, sex, ethnic origin, history of onset, predisposing factors, treatment, and outcome of treatment. Results The patients were all young adults with a median age of 31 years. The sex distribution was relatively equal, with 11 men and 9 women. All patients were Maori or Pacific Island Polynesians. Six patients gave a clear history of preceding trauma to the neck or oral cavity. Two recurrences were seen, both in patients who had had the sublingual gland excised via a cervical approach. Five patients sustained lingual nerve damage during surgery. Full function recovered in four patients, but the complication was still present in the fifth patient at 2 years, after which he was lost to follow‐up. Conclusions Plunging ranulas appear to occur with greater incidence in the Maori and Pacific Island Polynesian populations. The precise etiology of their predisposition is unknown, although local trauma or inherent mylohyoid dehiscences may play important roles. Removal of the sublingual gland via either a cervical or intraoral approach is important in the management of this condition. Excision of the pseudocyst is probably unnecessary and places surrounding structures at risk of damage, but a biopsy of the pseudocyst wall is important to confirm the diagnosis. © 1998 John Wiley & Sons, Inc. Head Neck 20: 63–68, 1998.

Pediatric Intraoral Ranulas: An Analysis of Nine Cases

“…An important feature in the histologic diagnosis is the absence of epithelial tissue in the pseudocyst wall (Davison et al 1998).…”

“…The etiology is unknown but it has been described in association with congenital anomalies, trauma, and disease of the sublingual gland (Davison et al 1998). An important feature in the histologic diagnosis is the absence of epithelial tissue in the pseudocyst wall (Davison et al 1998).…”

Plunging Ranula : A Case Report

“…5 It has been reported from 2 to 61 years of age with a slight female preponderance. 6 The pathophysiology involved in extravasation is hypertension in the duct due to obstruction leading to acinar rupture in the salivary gland and then extravasation of the mucus. The initial stage is a traumatic rupture of the excretory duct and the second stage is the extravasation and subsequent accumulation of saliva within the tissue, as shown by experimental studies.…”

A retrospective study of ranula in two centres in Malaysia

“…A plunging ranula is located near the upper airway and extends into the floor of the mouth. From the submandibular space, it can extend into the submental region, the contralateral side of the neck, the nasopharygeal area and up to the skull base, the retropharyngeal and into the upper mediastinum [5,6].…”