Transoral Robotic Surgery with Sialendoscopy for a Plunging Ranula

Abstract

Background/Aims: Plunging ranulas are oral mucoceles that often cannot be visualized directly and thus can be challenging to diagnose and differentiate from other neck lesions. Surgery is the preferred treatment option, but the optimal approach requires careful consideration. Methods: We report the case of a plunging ranula presenting as an isolated neck mass in a 33-year-old patient. This patient was treated with a novel transoral robotic surgery (TORS)-assisted approach aided by sialendoscopy. Results: TORS allowed for exceptional visualization and access to the plunging ranula and sublingual gland while avoiding critical neurovascular structures. The patient healed well without recurrence or complications. Conclusion: The TORS approach with sialendoscopy for plunging ranulas described in this case report shows promise and should be considered for certain clinical presentations. Additional studies evaluating the effectiveness of TORS for plunging ranulas may be indicated.

Contemporary Review of Submandibular Gland Sialolithiasis and Surgical Management Options

“…Transoral robotic surgery (TORS) utilizing the da Vinci surgical system has been utilized for various diseases of the head and neck, including resection of oncologic disease of the oropharynx, hypopharynx, larynx, and parapharyngeal spaces, as well as for salivary gland disorders, including removal of floor of mouth ranulas, tumors of the submandibular gland, and salivary gland stones [57,[67][68][69][70]. Robotic-assisted procedures applied specifically to submandibular stone management include the combined approach of TORS and sialendoscopy, as well as robotic sialadenectomy [57].…”

“…Additionally, compared to traditional transoral surgery, TORS offers an improved and direct view of the floor of the mouth, and thus allows the entire treatment team to collaborate and participate in the surgery [ 57 ]. The ability to perform a 4-handed surgery is an added benefit that facilitates working with multiple instruments in the small field of the oral cavity [ 68 ].…”