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Laccourreye O. Ranula at the dawn of the French Republic. Eur Ann Otorhinolaryngol Head Neck Dis 2024; 141:247-249. [PMID: 38702262 DOI: 10.1016/j.anorl.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2024]
Affiliation(s)
- O Laccourreye
- Université Paris Cité, Service d'Oto-rhino-laryngologie et de Chirurgie Cervico-Faciale, HEGP, AP-HP, 20, rue Leblanc, 75015 Paris, France.
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2
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Zhang HY, Su LW, Sun H, Rui CC, Wu Y. Sclerotherapy for the intraoral ranula with bleomycin: technical considerations and preliminary experience. BMC Oral Health 2024; 24:833. [PMID: 39048989 PMCID: PMC11267835 DOI: 10.1186/s12903-024-04633-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 07/18/2024] [Indexed: 07/27/2024] Open
Abstract
Ranula is a mucous cyst that occurs in the sublingual gland (SLG) in the floor of the mouth. It can be classified into two types based on origins: One is the the lesser sublingual gland (LSLG) in the anterior segment and the Rivini duct, which is connected to it, and the other is the greater sublingual gland (GSLG) in the posterior segment. Because of the anatomical characteristics, surgical resection of the cysts carries the risk of damaging adjacent tissues and has a high recurrence rate. Intralesional injection of sclerotherapy may be a better alternative treatment. We summarized 65 cases of ranula treated with intralesional injections of bleomycin(BML). According to the origin of the ranula, 60 cases were from the LSLG and the Rivini duct, and 5 cases were from the GSLG. The results showed that 60 cases of ranula from LSLG and Rivini ducts were 100% cured during the follow-up period. The median number of injections for all patients was 1.16. All 5 cases of ranula from the GSLG did not wholly recover. This study confirmed that BLM intralesional injection is a safe and effective treatment modality for cysts from LSLG or the ducts of Rivini rather than GSLG. Therefore, before treatment, it is necessary to determine the type and origin of the cyst by characterizing its morphology to ensure the effectiveness of the treatment.
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Affiliation(s)
- Hong-Yu Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Li-Wen Su
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Huan Sun
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of General Dentistry, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Chao-Chen Rui
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yang Wu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
- Department of Oral and Maxillofacial Surgery, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
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3
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Schmitz L, Büscheck F, Betz CS, Böttcher A. An unusual clinical presentation of a plunging ranula-The plunging ranula with extension to the vallecula. Clin Case Rep 2024; 12:e8964. [PMID: 38883226 PMCID: PMC11176729 DOI: 10.1002/ccr3.8964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 05/06/2024] [Accepted: 05/08/2024] [Indexed: 06/18/2024] Open
Abstract
Key Clinical Message A plunging ranula may present initially as an extensive vallecular cyst and correct diagnosis may be reached with the use of ultrasound, fluid aspiration for amylase detection, and MRI imaging. Abstract The ranula is a pseudocyst of the sublingual salivary gland and can be divided into two known subtypes. The simple ranula and plunging ranula. While the simple type can be found in the floor of the mouth, the plunging ranula usually pervades the mylohoid muscle and presents as a cervical swelling. The presented case should outline the difficulties in diagnostic and treatment of an uncommon expression of a mucocele above the mylohoid muscle without presenting either a cervical or an intraoral swelling, only extending towards the vallecula. We present a previously unreported clinical manifestation of a ranula of an 18-year old male, which extends posteriorly, remaining confined in the supramylohyoid muscle space. The cystic lesion protrudes in the oropharynx, and clinically appears as an extensive vallecular cyst. On magnetic resonance imaging the initial suspected diagnosis of a vallecular cyst was changed to the final diagnosis of a plunging ranula. The marsupialization of the cyst sac was performed. Outpatient follow-up revealed a persisting ostium, indicating a continuous extravasation of the sublingual gland. The present case report describes an unusual clinical presentation of a plunging ranula, remaining above the mylohyoid muscle and protruding into the oropharynx, misdirecting to the first suspected diagnosis of a vallecular cyst. The case highlights the useful contribution of the MRI imaging for differential diagnoses and the need for criteria to indicate further investigations.
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Affiliation(s)
- Lisa Schmitz
- Department of Otorhinolaryngology University Hospital Hamburg-Eppendorf Hamburg Germany
| | - Franziska Büscheck
- Department of Pathology University Hospital Hamburg-Eppendorf Hamburg Germany
| | - Christian Stefan Betz
- Department of Otorhinolaryngology University Hospital Hamburg-Eppendorf Hamburg Germany
| | - Arne Böttcher
- Department of Otorhinolaryngology University Hospital Hamburg-Eppendorf Hamburg Germany
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4
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Fauzi FA, Abdullah MF, Samsudin NA, Md Yusoff B. Surgical Management of Huge Ranula Resembling Double Tongue in Pediatric Patients: A Successful Treatment of Two Cases. Cureus 2024; 16:e57884. [PMID: 38725744 PMCID: PMC11079697 DOI: 10.7759/cureus.57884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2024] [Indexed: 05/12/2024] Open
Abstract
Ranula is a fluid collection in a pseudo cystic wall secondary to the damage of the sublingual salivary gland causing blockage of salivary flow, leading to the extravasation phenomena. The growth rate of ranula varies depending on its severity. Due to its tendency to recur, the gold standard management of ranula has yet to be decided. The authors described two cases of young girls with huge ranulas on the floor of the mouth (FOM) resembling double tongue, which caused pain and discomfort during mastication. Following surgical excision of the ranulas along with the affected sublingual glands, both cases demonstrated successful treatment outcomes with no recurrence observed during post-operative follow-up. These cases highlight the importance of surgical excision of ranulas and removal of affected sublingual glands to prevent recurrence.
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Affiliation(s)
- Fattirah Auni Fauzi
- Oral and Maxillofacial Surgery, Hospital Universiti Sains Malaysia, Kota Bharu, MYS
| | - Mohd Faizal Abdullah
- Oral and Maxillofacial Surgery, Hospital Universiti Sains Malaysia, Kota Bharu, MYS
- Oral and Maxillofacial Surgery, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu, MYS
| | - Norsamsu Arni Samsudin
- Pediatric Dentistry, Hospital Universiti Sains Malaysia, Kota Bharu, MYS
- Pediatric Dentistry, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu, MYS
| | - Bazli Md Yusoff
- Radiology, Hospital Universiti Sains Malaysia, Kota Bharu, MYS
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5
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Kaggare Puttaraju M, Manjunatha BS, Niranjan S. Outlandish manifestation of swelling in early childhood seen in the patient's floor of the mouth. BMJ Case Rep 2024; 17:e255733. [PMID: 38521513 PMCID: PMC10961554 DOI: 10.1136/bcr-2023-255733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2024] Open
Abstract
Ranula is a cyst-like growth that occurs in the oral cavity beneath the tongue. It consists of saliva from a ruptured salivary gland or duct. Rather than just flowing directly from the glands into the oral cavity, saliva permeates the nearby connective tissues and creates a bubble. A ranula could indeed appear at any time span in a person's life for inexplicable reasons. A trauma such as an oral operation, a facial blow or nibbling the lower lip may possibly start one. The following is a case study of an early childhood boy who reported with a swelling in the floor of the mouth with unknown aetiology from the last 6 months.
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Affiliation(s)
- Mahesh Kaggare Puttaraju
- Oral Medicine and Radiology, JSS Dental College and Hospital, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
| | - Bhari Sharanesha Manjunatha
- Basic Oral Medicine and Allied Dental Sciences, Faculty of Dentistry, Taif University, At'Taif, Saudi Arabia
| | - Sharath Niranjan
- Oral Medicine and Radiology, JSS Dental College and Hospital, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
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6
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Rodrigues Barros C, Caeiro Dos Santos Portugal Guerreiro F, Seixas-Martins J, Machado MDC. Recurrent Plunging Ranula Due to a Sublingual Ectopic Gland: A Rare Clinical Entity. Cureus 2024; 16:e52590. [PMID: 38371149 PMCID: PMC10874684 DOI: 10.7759/cureus.52590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2024] [Indexed: 02/20/2024] Open
Abstract
Ranula is a benign cystic lesion caused by the escape and collection of salivary mucus. Classically, it is divided into simple ranulas, a cystic mass in the floor of the mouth, and diving/plunging/cervical ranulas, a submandibular mass without apparent intraoral involvement. Although plunging ranula is a well-documented cause of neck swelling, its association with the presence of ectopic sublingual glands is extremely rare, with less than five cases reported. Other cervical cystic lesions may have the same clinical aspect; therefore, advanced diagnostic techniques like a CT scan or MRI play a critical role in early diagnosis. Different approaches have been used to treat ranulas, including non-invasive, minimally invasive, and surgical techniques. The purpose of this paper is to highlight a case report of a giant plunging ranula due to an anatomical aberration of the right sublingual gland, along with a significant literature review.
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7
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Kang YJ, Lee SS, Kim SG. Intraoral approach for the treatment of non‑infiltrating angiolipoma of the floor of the mouth in an elderly patient: A case report with review of the literature. Exp Ther Med 2023; 26:458. [PMID: 37614439 PMCID: PMC10443065 DOI: 10.3892/etm.2023.12157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 07/10/2023] [Indexed: 08/25/2023] Open
Abstract
A 75-year-old male patient visited Gangneung-Wonju National University Dental Hospital (Gangneung, South Korea) with a 35-mm fluctuant lesion on the floor of the mouth. It was a dome-shaped exophytic lesion with its top on Wharton's duct orifice area. The encapsulated lesion was excised cautiously and the final diagnosis was non-infiltrating angiolipoma. To the best of our knowledge, this is the first report of an intraoral approach for the treatment of a non-infiltrating angiolipoma on the floor of the mouth in an elderly patient. Differentiating it from a ranula is essential for the surgical approach and, as there is a higher transition to infiltrating angiolipoma, definite treatment should be considered in elderly patients.
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Affiliation(s)
- Yei-Jin Kang
- Department of Oral and Maxillofacial Surgery, Gangneung-Wonju National University Dental Hospital, Gangneung, Gangwon 25457, Republic of Korea
| | - Sang-Shin Lee
- Department of Oral and Maxillofacial Pathology, College of Dentistry, Gangneung-Wonju National University, Gangneung, Gangwon 25457, Republic of Korea
| | - Seong-Gon Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, Gangneung, Gangwon 25457, Republic of Korea
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8
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Rao AR, Parakh H, Rao PMM, Kumar KY, Qadeer E. Unusual Presentation of a Congenital Ranula Cyst in a Newborn. Cureus 2023; 15:e38749. [PMID: 37303374 PMCID: PMC10248586 DOI: 10.7759/cureus.38749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2023] [Indexed: 06/13/2023] Open
Abstract
Congenital ranula cysts are rare, benign cysts that arise from the obstruction or rupture of the sublingual gland ducts in the oral cavity of newborns. Here, we present a case of a congenital ranula cyst in a newborn, highlighting the clinical presentation, diagnosis, and management of this rare condition. The neonate presented with a smooth, painless, and non-tender mass in the floor of the mouth, which was identified as a sublingual cyst via ultrasonography. The neonate underwent successful surgical excision of the cyst, with no complications or recurrence observed during the follow-up period. Congenital ranula cysts are a rare but treatable condition that can present in the oral cavity of newborns, and early diagnosis and surgical excision are crucial to prevent complications and ensure optimal outcomes. Healthcare providers should consider congenital ranula cysts as a differential diagnosis for any newborn presenting with a mass in the oral cavity.
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Affiliation(s)
- A Rupesh Rao
- Pediatrics and Child Health, Datta Meghe Institute of Medical Sciences (DMIMS), Wardha, IND
| | - Hemant Parakh
- Neonatology, Hope Children's Hospital, Hyderabad, IND
| | - P Madan Mohan Rao
- Pediatrics and Child Health, Hope Children's Hospital, Hyderabad, IND
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9
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Song T, Chiu W, de Paiva Leite S, Ahmad Z, Mahadevan M, Harrison JD, Jain P, Morton RP. Amylase as a Diagnostic Tool for Plunging Ranula: Clinical Series and Description of the Technique. Laryngoscope 2023; 133:535-538. [PMID: 35670504 DOI: 10.1002/lary.30243] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/23/2022] [Accepted: 05/06/2022] [Indexed: 11/08/2022]
Abstract
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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Affiliation(s)
- Thomas Song
- Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand
| | - Weldon Chiu
- Biochemistry laboratory, Middlemore Hospital, Counties Manukau District Health Board, Auckland, New Zealand
| | - Sandro de Paiva Leite
- Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand.,Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Zahoor Ahmad
- Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand.,Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Murali Mahadevan
- Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand.,Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - John D Harrison
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Prabha Jain
- Department of Radiology, Counties Manukau District Health Board, Auckland, New Zealand
| | - Randall P Morton
- Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand.,Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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10
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Bukhary S. The diagnostic challenge of sialolithiasis. J Microsc Ultrastruct 2023. [DOI: 10.4103/jmau.jmau_92_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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11
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Gontarz M, Bargiel J, Gąsiorowski K, Marecik T, Szczurowski P, Zapała J, Gałązka K, Wyszyńska-Pawelec G. Surgical Treatment of Sublingual Gland Ranulas. Int Arch Otorhinolaryngol 2022; 27:e296-e301. [PMID: 37125362 PMCID: PMC10147468 DOI: 10.1055/s-0042-1744166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 01/17/2022] [Indexed: 12/24/2022] Open
Abstract
Abstract
Introduction Ranulas are divided into oral (OR) and plunging (PR) and comprise the most common pathology of the sublingual gland. This study presents a case series of patients operated due to OR and PR within different type of modalities in a 1-year period.
Objective The aim of this study is to determine the optimal surgical treatment of ranulas based on our results as well as in the literature review.
Methods The medical charts of 7 patients with sublingual gland ranulas treated in 2020 were reviewed.
Results The median age of the patients was 19. Three patients with OR were treated by marsupialization, micromarsupialization, and sublingual gland excision. Four patients with PR were operated via cervical approach in three cases and intraoral approach in one case. No recurrence was observed in 14 months of follow-up, on average.
Conclusion Micromarsupialization should be consider as the primary treatment for OR. In case of recurrent OR and primary or recurrent PR, the best results might be obtained by radical excision of the sublingual gland, which can be performed without resection of the ranula sac with the intraoral approach.
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Affiliation(s)
- Michał Gontarz
- Department of Cranio-Maxillofacial Surgery, Jagiellonian University Medical College, Cracow, Poland
- University Hospital, Cracow, Poland
| | - Jakub Bargiel
- Department of Cranio-Maxillofacial Surgery, Jagiellonian University Medical College, Cracow, Poland
- University Hospital, Cracow, Poland
| | - Krzysztof Gąsiorowski
- Department of Cranio-Maxillofacial Surgery, Jagiellonian University Medical College, Cracow, Poland
- University Hospital, Cracow, Poland
| | - Tomasz Marecik
- Department of Cranio-Maxillofacial Surgery, Jagiellonian University Medical College, Cracow, Poland
- University Hospital, Cracow, Poland
| | - Paweł Szczurowski
- Department of Cranio-Maxillofacial Surgery, Jagiellonian University Medical College, Cracow, Poland
- University Hospital, Cracow, Poland
| | - Jan Zapała
- Department of Cranio-Maxillofacial Surgery, Jagiellonian University Medical College, Cracow, Poland
- University Hospital, Cracow, Poland
| | - Krystyna Gałązka
- University Hospital, Cracow, Poland
- Department of Pathology, Jagiellonian University Medical College, Cracow, Poland
| | - Grażyna Wyszyńska-Pawelec
- Department of Cranio-Maxillofacial Surgery, Jagiellonian University Medical College, Cracow, Poland
- University Hospital, Cracow, Poland
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Miranda GGB, Chaves-Junior SDC, Lopes MP, da Rocha TB, Colares DF, Ito FA, Cavalcante IL, Cavalcante RB, de Andrade BAB, Nonaka CFW, Alves PM, de Albuquerque-Júnior RLC, Cunha JLS. Oral mucoceles: A Brazillian Multicenter Study of 1,901 Cases. Braz Dent J 2022; 33:81-90. [PMID: 36287502 PMCID: PMC9645162 DOI: 10.1590/0103-6440202204965] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 08/23/2022] [Indexed: 06/16/2023] Open
Abstract
Oral mucocele (OM) is the most common lesion of minor salivary glands. The present study aimed to report the clinical and demographic features of a large series of OMs and identify possible predictive variables associated with the recurrence rate of these lesions. A retrospective descriptive cross-sectional study was performed. A total of 43,754 biopsy records from four pathology services in Brazil were analyzed. All cases of OMs were reviewed, and clinical and demographic data were collected. The study comprised 1,002 females (56.2%) and 782 males (43.8%), with a mean age of 19.8±16.4 years (range: 01-87 years) and a 1.3:1 female-to-male ratio. The lower lip (n=1,160; 67.4%), and floor of the mouth (n=172; 10.0%), were the most common affected sites, presenting clinically as nodules (n=978; 79.4%) of smooth surface (n=428; 77.5%) and normal color (n=768, 46.7%). Excisional biopsy was the treatment in most cases (n=1,392; 78.0%). Recurrent OMs represented 6.2% of all diagnosed cases (n=117). OMs recurred more commonly in younger patients (aged<20 years) (p<0.0001), in lesions larger than 2 cm in diameter (p<0.0001), and in those located in the ventral tongue (p=0.0351). Also, recurrence rates were higher significantly in cases treated with laser surgery than in those with conventional surgery (p=0.0005). Patients with OMs should be carefully informed of its possible recurrence, especially when found on the ventral tongue of young patients.
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Affiliation(s)
- Georgea Gabriela Barreto Miranda
- Laboratory of Morphology and Experimental Pathology, Institute of Technology and Research, Tiradentes University(UNIT), Aracaju, Brazil
| | | | | | - Talytha Barbosa da Rocha
- Postgraduate Program of Dentistry, Department of Dentistry, State University of Paraíba (UEPB), Campina Grande, Paraíba, Brazil
| | - Débora Frota Colares
- Departament of Dentistry, Federal University of Rio Grande do Norte(UFRN), Natal, Brazil
| | - Fábio Augusto Ito
- Department of Oral Medicine and Pediatric Dentistry, State University of Londrina (UEL), Londrina, Brazil
| | | | | | | | - Cassiano Francisco Weege Nonaka
- Postgraduate Program of Dentistry, Department of Dentistry, State University of Paraíba (UEPB), Campina Grande, Paraíba, Brazil
| | - Pollianna Muniz Alves
- Postgraduate Program of Dentistry, Department of Dentistry, State University of Paraíba (UEPB), Campina Grande, Paraíba, Brazil
| | | | - John Lennon Silva Cunha
- Postgraduate Program of Dentistry, Department of Dentistry, State University of Paraíba (UEPB), Campina Grande, Paraíba, Brazil
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13
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Gupta A, Bansal A, Verma A, Naranje P, Sangwan A. Imperforate submandibular duct in an infant. J Paediatr Child Health 2022; 58:921-923. [PMID: 34529315 DOI: 10.1111/jpc.15745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 09/03/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Amit Gupta
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Abhinav Bansal
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Ajay Verma
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Priyanka Naranje
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Ankit Sangwan
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
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14
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Jawanda MK, Grewal HK, Gupta S, Sharma V, Narula R. Spindle Cell Lipoma Occurring in the Submandibular Space: Fifth Case Reported along with a Concise Review of the Literature. ACTA MEDICA (HRADEC KRÁLOVÉ) 2021; 64:174-182. [PMID: 34779384 DOI: 10.14712/18059694.2021.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Spindle cell lipoma (SCL) is an uncommon histological variant of lipoma that accounts for 1.5% of all adipose tumors. It rarely occurs in the oral cavity. The most common sites of involvement are the buccal mucosa, tongue, lip, alveolar mucosa, gingiva, and palate. Submandibular space is a very rare site of occurrence for SCL. When occurs in this site, SCL mainly involves the 4th-7th decade with a female predominance. Due to wide communications of submandibular space, the actual extent and appearance of the lesions present here gets masked up especially those involving the deeper tissues leading to an inaccurate diagnosis. Wide overlap of clinical and histopathological features of SCL to other clinical pathologies leads to a challenging task for the clinicians to reach an accurate diagnosis. To our knowledge, only four cases of intraoral SCL involving the submandibular region directly or indirectly have been reported in the literature. Here we represent another rare case of SCL in an 18-year-old male patient along with a concise review of the literature. This case appears to be quite rare due to its location (submandibular space), age, and sex of the patient (18/M).
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Affiliation(s)
- Manveen Kaur Jawanda
- Dept. of Oral Pathology and Microbiology & Forensic odontology. Laxmi bai institute of dental sciences and hospital, Patiala, Punjab, India
| | | | - Sonia Gupta
- Dept. of Oral Pathology and Microbiology & Forensic odontology, Rayat Bahra Dental college and hospital, Mohali, Punjab, India.
| | - Vineet Sharma
- Dept. of Conservative Dentistry, Laxmi bai institute of dental sciences and hospital, Patiala, Punjab, India
| | - Ravi Narula
- Dept. of Oral and Maxillofacial surgery, Guru Nanak Dev Dental College and Research Institute, Sunam, Punjab, India
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15
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Rare Presentation of Simultaneous Bilateral Oral Ranula Treated by Marsupialization: Case Report and Review of the Literature. Indian J Surg 2021. [DOI: 10.1007/s12262-021-03130-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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16
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A Giant Diving Ranula Extending to the Skull Base in Pediatric Age. J Craniofac Surg 2021; 32:e515-e517. [PMID: 34319685 DOI: 10.1097/scs.0000000000007527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT 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 × 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.
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Manna S, Bageac DV, Berenstein A, Sinclair CF, Kirke D, De Leacy R. Bleomycin sclerotherapy following doxycycline lavage in the treatment of ranulas: A retrospective analysis and review of the literature. Neuroradiol J 2021; 34:449-455. [PMID: 33832375 DOI: 10.1177/19714009211008790] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE A ranula is a mucus-filled salivary pseudocyst that forms in the floor of the mouth, commonly arising from the sublingual or submandibular salivary glands following obstruction or trauma. Complete excision of the injured gland and removal of the cyst content is the first-choice therapy, but has the potential for complications related to injury to nearby structures. As such, minimally invasive approaches such as percutaneous sclerotherapy have been investigated. We aim to contribute to the literature by assessing the efficacy and safety of our technique through our experience with 18 patients over the last decade. METHODS This retrospective study evaluated 18 patients with intraoral and plunging ranulas treated by percutaneous bleomycin ablation. The primary endpoint was the treatment result. Secondary endpoints included bleomycin dosage and complications. RESULTS The study evaluated 12 males and six females with a median age of 23.5 years (range 13-39 years). At a final follow-up of at least 2 months (6.5±5.5 months), four patients demonstrated complete response (22%) and 14 patients demonstrated residual presence, recurrence, or regrowth of the lesion (78%). There were no statistically significant associations between outcomes and history of prior treatment, number of treatments, and size or type of ranula. No complications were noted. CONCLUSIONS Our findings indicate that bleomycin, while safe for use in various head and neck malformations, is of limited utility in ranula therapy when the offending gland is not addressed primarily.
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Affiliation(s)
- Sayan Manna
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, USA
| | - Devin V Bageac
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, USA
| | | | - Catherine F Sinclair
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, USA
| | - Diana Kirke
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, USA
| | - Reade De Leacy
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, USA
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Abstract
Simple ranula is a cystic swelling confined to the floor of mouth while plunging ranula presents with extension to the neck. Congenital ranula presenting with symptoms of feeding difficulties is a very rare occurrence. There is paucity of literature regarding the management of large congenital ranula. Varied treatment options are described for the management of ranula with variable recurrence rate. In paediatric and adult patients, ranula is considered as a type of extravasation cyst and removal of sublingual gland is advocated to remove the sources of extravasation. Congenital ranula is usually a variant of retention cyst and should be treated with marsupialisation or simple excision of cyst while cyst excision with sublingual sialadenectomy should be reserved for recurrent cases.
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Affiliation(s)
| | | | - Nighat Hussain
- Department of Pathology, AIIMS, Raipur, Chhattisgarh, India
| | - Rashmi Dubey
- Department of Anesthesia, AIIMS, Raipur, Chhattisgarh, India
| | - Sunita Singh
- Department of Paediatric Surgery, AIIMS, Raipur, Chhattisgarh, India
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Liman ARUA, Tuang GJ, Mansor M. Plunging Ranula. EAR, NOSE & THROAT JOURNAL 2020; 100:1004S-1005S. [PMID: 32525702 DOI: 10.1177/0145561320927828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Abdul Ruhi Ul Azim Liman
- Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Selayang, Batu Caves, Malaysia
| | - Geng Ju Tuang
- Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Selayang, Batu Caves, Malaysia
| | - Masaany Mansor
- Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Selayang, Batu Caves, Malaysia
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20
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ALTIN F, ALİMOĞLU Y. Retrospective analysis of ranula patients managed with surgical treatment. ENT UPDATES 2020. [DOI: 10.32448/entupdates.688446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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21
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Hassan BM, Intan Suhana MA, Megat Mustaqim MI. Bluish swelling on the floor of the mouth. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2020; 15:64-67. [PMID: 32284810 PMCID: PMC7136672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- B M Hassan
- MD (UPM), MMed (Family Med) (UKM) Faculty of Medicine, University Sultan Zainal Abidin, Medical Campus 20400, Kuala Terengganu Malaysia
| | - M A Intan Suhana
- DDS (UKM), PhD (UK) Faculty of Medicine University Sultan Zainal Abidin Medical Campus 20400, Kuala Terengganu Malaysia
| | - M I Megat Mustaqim
- MBBS (USIM), Master of Occupational Health and Safety Science (Australia) Faculty of Medicine, University Sultan Zainal Abidin, Medical Campus 20400, Kuala Terengganu Malaysia
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22
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Syebele K, Munzhelele TI. The anatomical basis and rational for the transoral approach during the surgical excision of the sublingual salivary gland for the management of plunging ranula. Am J Otolaryngol 2020; 41:102371. [PMID: 31917022 DOI: 10.1016/j.amjoto.2019.102371] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 12/08/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE The aim of this study was to illustrate and confirm that the complete intraoral excision of the sublingual gland alone, is anatomically the most rational approach, for the management of plunging ranula. MATERIAL AND METHODS We retrospectively reviewed clinical charts of diagnosed HIV-infected patients presenting with plunging ranula. The intraoral approach was used for the complete excision of the sublingual gland with evacuation of the pseudocystic content only. Neither extra oral approach, nor ranula dissection / drainage was performed. The surgical procedure was performed using local anesthesia. Pre- and postoperative MRI-scan investigations were recorded. Histological reports were documented to confirm the diagnosis of oral mucocele. Patients were clinically monitored. RESULTS We identified 90 adults presenting with oral mucocele, type ranula. Seventy (77%) of them were diagnosed with HIV infection. Plunging ranula was recorded in 35 (50%) patients from the latter group. The study enrolled 11 operated patients whose files contained useable data, including an acceptable follow-up period. The postoperative follow-up period ranged from three to 15 months. The clinical and postoperative MRI-scans of operated patients demonstrated satisfactory results. There were neither postoperative complications nor recurrence of ranula reported. CONCLUSION The location of the sublingual gland in the floor of the mouth coupled with the physio-pathogenesis of the plunging ranula, makes the transoral complete excision of the offending gland, with the intraoral evacuation of the pseudocyst, anatomically the most rational approach for plunging ranula management. There is no need for cervical approach, ranula dissection and/or postoperative placement of drainage.
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Thyroglossal duct cysts and site-specific differential diagnoses: imaging findings with emphasis on ultrasound assessment. J Ultrasound 2020; 23:139-149. [PMID: 32052384 DOI: 10.1007/s40477-020-00433-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 01/29/2020] [Indexed: 02/07/2023] Open
Abstract
Thyroglossal duct cysts (TGDCs) are the most common congenital abnormality of the neck, accounting for approximately 70% of congenital neck lesions. Two-thirds of thyroglossal duct anomalies are diagnosed within the first three decades of life, with more than half being identified before 10 years of age. The age of presentation, clinical examination and imaging are essential for an accurate diagnosis. This review aims to summarize the imaging findings of TGDCs and their main differential diagnoses with emphasis on ultrasound assessment. A focus on site-specific key differentiating between them is also addressed.
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Abstract
Ranulas are mucoceles located on the floor of the mouth. The main form of treatment for these lesions is surgical excision, but this can lead to complications such as hemorrhage, recurrence of the lesion, and damage to the lingual nerve. Thus, other therapeutic modalities are indicated, such as modified micromarsupialization, which is a simple technique and not associated with recurrences, and without the need of a new intervention in the postoperative period. An 11-year-old female child, nonwhite, presented with bubble-shaped lesion located on floor of the mouth, on the left side, with exophytic growth, sessile base, bluish coloration, measuring about 4.0 cm in diameter, showing well-defined limits, well-delimited contours and borders, smooth surface, and softened consistency. Under the diagnostic hypothesis of the ranula, a modified micromarsupialization was performed. After 90 days of observation, complete regression and repair of the lesion were observed, without recurrence. Modified micromarsupialization is a simple therapeutic modality, low cost, and well-tolerated by the patient, mainly the pediatric one, being considered very effective in the treatment of lesions of difficult clinical management, as the ranula.
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Chung Y, Cho Y, Kim B. Comparison of outcomes of treatment for ranula: a proportion meta-analysis. Br J Oral Maxillofac Surg 2019; 57:620-626. [DOI: 10.1016/j.bjoms.2019.06.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 06/06/2019] [Indexed: 12/20/2022]
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Chen JX, Zenga J, Emerick K, Deschler D. Sublingual gland excision for the surgical management of plunging ranula. Am J Otolaryngol 2018; 39:497-500. [PMID: 30017374 DOI: 10.1016/j.amjoto.2018.05.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Accepted: 05/26/2018] [Indexed: 11/15/2022]
Abstract
OBJECTIVE A plunging ranula is a pseudocystic collection of mucin extravasated from the sublingual gland into the floor of mouth and through the mylohyoid muscle into the neck. While the lining of a ranula is non-secreting and resection of the sublingual gland is adequate for simple sublingual mucoceles, many surgeons attempt to address plunging ranulas with extensive transoral and transcervical dissections. We review our experience managing plunging ranulas with intraoral sublingual gland excision and ranula drainage alone. METHODS This is a case series of patients with plunging ranulas who underwent transoral sublingual gland excision and ranula drainage in the past 10 years at the Massachusetts Eye and Ear. All ranulas were confirmed by radiographic imaging. Data were gathered from the medical record and telephone surveys. RESULTS Twenty-one patients with 22 distinct ranulas underwent this surgical approach. Average ranula size on imaging was 4.3 cm (SD = 1.3). Thirteen patients with 14 ranulas were followed up for greater than 6 months while the remaining 7 patients were lost to follow-up. Median follow-up for the 13 patients was 30 months (range 6 to 80). One ranula recurred requiring excision of residual sublingual gland (7%). One patient developed a local infection that was treated with antibiotics (7%). No long term complications were reported. CONCLUSION Simple transoral excision of the sublingual gland with ranula drainage is sufficient for treatment of plunging ranulas. It is essential to obtain a full resection of the gland to prevent relapse. This limited approach has low rates of complications and ranula recurrence.
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Affiliation(s)
- Jenny X Chen
- Department of Otolaryngology, Massachusetts Eye and Ear, Boston, MA 02114, United States
| | - Joseph Zenga
- Department of Otolaryngology, Massachusetts Eye and Ear, Boston, MA 02114, United States; Division of Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, 02114, United States
| | - Kevin Emerick
- Department of Otolaryngology, Massachusetts Eye and Ear, Boston, MA 02114, United States; Division of Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, 02114, United States
| | - Daniel Deschler
- Department of Otolaryngology, Massachusetts Eye and Ear, Boston, MA 02114, United States; Division of Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, 02114, United States.
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Affiliation(s)
- R P Morton
- Department of Surgery, University of Auckland, Auckland, New Zealand.
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28
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The Pathophysiological Basis and Surgical Management of Ranula are Established. World J Surg 2018; 42:1208-1209. [PMID: 28741194 DOI: 10.1007/s00268-017-4148-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kokong D, Iduh A, Chukwu I, Mugu J, Nuhu S, Augustine S. The Pathophysiological Basis and Surgical Management of Ranula are Established: Reply. World J Surg 2018; 42:1210-1211. [PMID: 29330593 DOI: 10.1007/s00268-017-4403-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Daniel Kokong
- Department of Oto-Rhinolaryngology- Head & Neck Surgery, College of Medicine, University of Jos & Jos University Teaching Hospital, PMB 2076, Jos, Plateau state, Nigeria.
| | - Augustine Iduh
- Department of Oto-Rhinolaryngology- Head & Neck Surgery, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - Ikechukwu Chukwu
- Department of Oto-Rhinolaryngology- Head & Neck Surgery, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - Joyce Mugu
- Department of Oto-Rhinolaryngology- Head & Neck Surgery, Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - Samuel Nuhu
- Department of Anaesthesia, College of Medicine, University of Jos & Jos University Teaching Hospital, Jos, Plateau State, Nigeria
| | - Sule Augustine
- Department of General Surgery, College of Medicine, University of Jos & Jos University Teaching Hospital, Jos, Plateau State, Nigeria
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Abstract
A number of salivary gland diseases may present with a wide variety of symptoms to the general dental practitioner, or may appear as unexpected findings on dental radiographs. Careful clinical examination in combination with appropriate imaging will assist practitioners in identifying whether further investigation or referral is required. This article explores the main types of salivary gland diseases and their potential pathology.
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Lomas J, Chandran D, Whitfield BCS. Surgical management of plunging ranulas: a 10-year case series in South East Queensland. ANZ J Surg 2017; 88:1043-1046. [PMID: 29266658 DOI: 10.1111/ans.14356] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 11/05/2017] [Accepted: 11/18/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Plunging ranulas are rare mucous extravasation pseudocysts that arise in the floor of the mouth and pass into the submandibular space of the neck. The aim of this study was to investigate the diagnosis, surgical management and outcomes of patients with a plunging ranula at our institution in South East Queensland over a 10-year period. METHODS A retrospective analysis of adult patients diagnosed with and treated for plunging ranula between 2006 and 2016 at Logan Hospital was conducted. Patient demographics, preoperative investigations, surgical management and post-operative outcomes were collected from medical records. RESULTS A total of 18 adult patients were treated for plunging ranula. Of the 18 cases, 17 were treated via transoral excision of the sublingual gland. The mean age at presentation was 28.8 years with a 3:1 female to male predominance. Fifty-six percent of patients were of Polynesian descent. The success rate was 94% with only one patient experiencing recurrence and requiring re-excision of remnant sublingual gland tissue. Three patients (17%) developed complications related to post-operative bleeding. There was a slight predominance for right-sided disease (56%) compared with left and one case of bilateral plunging ranulas in this series. CONCLUSION This study demonstrates that excision of the sublingual gland is an effective and safe treatment for plunging ranula. The majority of plunging ranulas occur in patients aged <30 years with a higher incidence in patients of Polynesian heritage, which is consistent with previous studies suggesting a possible underlying genetic predisposition for this condition.
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Affiliation(s)
- Jonathan Lomas
- Department of Otolaryngology and Head and Neck Surgery, Logan Hospital, Logan City, Queensland, Australia
| | - Dhinashin Chandran
- Department of Otolaryngology and Head and Neck Surgery, Darling Downs Hospital and Health Service, Toowoomba, Queensland, Australia
| | - Bernard C S Whitfield
- Department of Otolaryngology and Head and Neck Surgery, Logan Hospital, Logan City, Queensland, Australia
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