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Fiorino A, Staderini E, Diana R, Rengo C, Gallenzi P. New Conservative Approach for the Management of Recurrent Sublingual Ranula-A Case Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2398. [PMID: 36767764 PMCID: PMC9915898 DOI: 10.3390/ijerph20032398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/14/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
Ranula is a rare and benign extravasation mucocele that is clinically characterized by asymptomatic sublingual or submandibular masses. Surgical excision is considered the most effective treatment approach, but it has been associated with high invasiveness and several complications (hemorrhage, damage to Wharton's duct, and lingual nerve injury). Over the past decade, more conservative therapies have been rapidly disseminated into clinical practice to seek a more effective and less traumatic approach for young patients. In this report, an 8-year-old female with an asymptomatic, recurrent sublingual ranula was treated using a conservative approach with marsupialization and an intracystic injection of a plaque remover (Hybenx® gel). After incision of the cystic dome, Hybenx® gel was applied into the cystic lumen for 20 seconds and then aspirated; next, the area was rinsed thoroughly with sterile saline solution before suturing. Ultrasound re-evaluation at 10 months and intraoral clinical examination at 24 months confirmed the absence of relapse. Our results support the hypothesis that marsupialization combined with intracystic injection of Hybenx® gel could be an encouraging conservative treatment alternative for recurrent sublingual ranula in children. Further randomized controlled trials are needed to test this hypothesis.
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Affiliation(s)
- Antonino Fiorino
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, “Federico II” University of Naples, 80131 Naples, Italy
| | - Edoardo Staderini
- Postgraduate School of Orthodontics, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Rosalba Diana
- Postgraduate School of Orthodontics, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Carlo Rengo
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
| | - Patrizia Gallenzi
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, “Federico II” University of Naples, 80131 Naples, Italy
- UOC Odontoiatria Generale e Ortodonzia, Dipartimento di Testa-Collo e Organi di Senso, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
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Elnager M, Udeabor SE, Elfadeel ASA, Onwuka CI, Hamid MMM, Alsubaie YMA. Modified micromarsupialization technique as an alternative primary treatment for ranulas: A case series in a resource-challenged economy. Clin Exp Dent Res 2022; 8:1434-1439. [PMID: 36196590 PMCID: PMC9760142 DOI: 10.1002/cre2.627] [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: 01/22/2022] [Revised: 06/26/2022] [Accepted: 06/28/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES Ranula is one of the commonest salivary gland cysts that mostly occur due to mucus extravasation from the sublingual salivary gland. Treatment of this lesion is still somewhat shrouded in controversy and varies from conservative treatment to surgical excision of the causative gland. MATERIALS AND METHODS This was a case series in quasi-experimental design that evaluated the outcome and complications of the modified micromarsupialization technique as a newly introduced treatment at our center for simple sublingual ranula over a 2-year period. RESULTS Twenty patients were treated by the modified micromarsupialization technique and followed up for 1 year. There was complete resolution following this technique in 17 patients (85%) with no evidence of recurrence or complications, whereas 2 patients (10%) showed partial resolution and the remaining 1 patient (5%) showed a failure and recurrence. The age of the patient, the size of the ranula, and the retention of sutures throughout the study period did not significantly affect the treatment outcome. CONCLUSIONS The modified micromarsupialization technique was a simple and effective treatment that should be used as a primary treatment option for simple ranulas and we recommend it to be the first-choice treatment before surgical excision of the sublingual gland, especially in a resource-challenged economy like ours.
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Affiliation(s)
- Mutassim Elnager
- Department of Oral and Maxillofacial Surgery, College of DentistryKing Khalid UniversityAbhaSaudi Arabia
| | - Samuel E. Udeabor
- Department of Oral and Maxillofacial Surgery, College of DentistryKing Khalid UniversityAbhaSaudi Arabia
| | - Abosofyan S. A. Elfadeel
- Department of Oral and Maxillofacial Surgery, College of DentistryKing Khalid UniversityAbhaSaudi Arabia
| | - Chidozie I. Onwuka
- Department of Oral and Maxillofacial Surgery, College of DentistryKing Khalid UniversityAbhaSaudi Arabia
| | - Mashail M. M. Hamid
- Department of Oral and Maxillofacial Surgery, College of DentistryKing Khalid UniversityAbhaSaudi Arabia
| | - Yassin M. A. Alsubaie
- Department of Oral and Maxillofacial SurgeryKhartoum Teaching Dental HospitalKhartoumSudan
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Wendt M, Papatziamos G, Munck-Wikland E, Marklund L. Sclerotherapy of ranulas with OK-432 - a prospective, randomized, double-blinded placebo-controlled study. Acta Otolaryngol 2021; 141:531-536. [PMID: 33775200 DOI: 10.1080/00016489.2021.1889660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Ranula is a rare benign cystic lesion in the floor of the mouth, which can herniate through the mylohyoid muscle and become a plunging ranula. Treatment for ranulas is currently surgical excision of the sublingual gland. Sclerotherapy with OK-432 is a well-established treatment of lymphatic malformations, but not yet thoroughly evaluated on ranulas. Objectives: To evaluate sclerotherapy of ranulas with OK-432 in a randomized double-blinded trial. MATERIALS AND METHODS 20 patients with plunging or intraoral ranula were randomized to two double-blinded injections with OK-432 or saline. Effect on the ranula and evaluation of symptoms and QOL were investigated. RESULTS Treatment response differed significantly between OK-432 and placebo, p = .041(student's T-test). All patients with intraoral ranulas had a complete response, but only 1/4 of the patients with plunging ranula. The inflammatory reaction after injection with OK-432 caused a mild to moderate impact on QOL. No serious complications were observed. CONCLUSION This study suggests that sclerotherapy with OK-432 in ranula is a very effective treatment for intraoral ranulas, but possibly less useful in plunging ranulas. SIGNIFICANCE This is a limited study, but we believe that sclerotherapy with OK-432 should be recommended as primary treatment at least for intraoral ranulas.
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Affiliation(s)
- Malin Wendt
- Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Medical Unit Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden
| | - Georgios Papatziamos
- Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Medical Unit Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden
| | - Eva Munck-Wikland
- Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Medical Unit Head Neck, Lung and Skin Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Linda Marklund
- Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Medical Unit Head Neck, Lung and Skin Cancer, Karolinska University Hospital, Stockholm, Sweden
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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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Talmor G, Nguyen B, Mir G, Badash I, Kaye R, Caloway C. Sclerotherapy for Benign Cystic Lesions of the Head and Neck: Systematic Review of 474 Cases. Otolaryngol Head Neck Surg 2021; 165:775-783. [PMID: 33755513 DOI: 10.1177/01945998211000448] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The role of sclerotherapy for vascular lesions of the head and neck is well established. However, the efficacy of sclerotherapy for benign cystic lesions of the head and neck is less clear. The objective of this review is to determine the efficacy and safety of sclerotherapy for benign cystic lesions of the head and neck. DATA SOURCES PubMed/MEDLINE, Cochrane Library, and Embase. REVIEW METHODS The PRISMA guidelines (Preferred Reporting Systems for Systematic Reviews and Meta-analyses) were followed for this systematic review. Studies of patients with benign head and neck cystic masses treated primarily with sclerotherapy were included. Thirty-two studies met criteria for inclusion. RESULTS A total of 474 cases of sclerotherapy were reviewed. Agents comprised OK-432, ethanol, doxycycline, tetracycline, and bleomycin. Lesions in the analysis were ranula, thyroglossal duct cyst, branchial cleft cyst, benign lymphoepithelial cyst, parotid cyst, thoracic duct cyst, and unspecified lateral neck cyst. A total of 287 patients (60.5%) had a complete response; 132 (27.9%) had a partial response; and 55 (11.6%) had no response. OK-432 was the most widely utilized agent, with a higher rate of complete response than that of ethanol (62.0% vs 39.4%, P = .015). Fifty-three cases (11.2%) required further surgical management. One case of laryngeal edema was reported and managed nonoperatively. CONCLUSION Sclerotherapy appears to be a safe and efficacious option for benign cystic lesions if malignancy is reliably excluded. Efficacy rates are comparable to those of sclerotherapy for vascular malformations. The rate of serious complications is low, with 1 incident of airway edema reported in the literature.
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Affiliation(s)
- Guy Talmor
- Department of Otolaryngology-Head and Neck Surgery, Rutgers-New Jersey Medical School, Newark, New Jersey, USA
| | - Brandon Nguyen
- Department of Otolaryngology-Head and Neck Surgery, Rutgers-New Jersey Medical School, Newark, New Jersey, USA
| | - Ghayoour Mir
- Department of Otolaryngology-Head and Neck Surgery, Rutgers-New Jersey Medical School, Newark, New Jersey, USA
| | - Ido Badash
- Caruso Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles, California, USA
| | - Rachel Kaye
- Department of Otolaryngology-Head and Neck Surgery, Rutgers-New Jersey Medical School, Newark, New Jersey, USA
| | - Christen Caloway
- Department of Otolaryngology-Head and Neck Surgery, Rutgers-New Jersey Medical School, Newark, New Jersey, USA
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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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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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Kong D, Zhang D, Cui Q, Wang K, Tang J, Liu Z, Wu G. Sapylin (OK-432) alters inflammation and angiogenesis in vivo and vitro. Biomed Pharmacother 2019; 113:108706. [PMID: 30844656 DOI: 10.1016/j.biopha.2019.108706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 02/13/2019] [Accepted: 02/19/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The occurrence of seroma formation and long-term wound healing remain challenging complications after modified radical mastectomy. Sapylin is a drug used to reduce seroma formation and enhance wound closure, but these results remain controversial. We aimed to investigate the potential mechanism. METHODS A prospective, consecutive cohort study included 120 patients diagnosed with breast cancer who underwent modified radical mastectomy was designed. Patients were randomized into two group, using or not using OK-432 (sixty patients per group) during surgeries. Patients' drainage fluids were collected for three days after surgery. Inflammatory cytokines and chemokines were measured with ELISA assays. The proliferative, migratory, and angiogenic capacity of HUVEC and HFL1 cells HUVEC and HFL1 cells were measured after being treated with drainage fluids. RESULTS Our clinic data showed that there was no statistical significance between the two groups in patient characteristics before surgery. However, the outcomes of patients in experimental group were significantly better than those in control group. In vitro studies, the results of ELISA assays showed that several cytokines, including IL-1a, IL-6, TGF-β1, bFGF and VEGF were increased in the drainage fluids treated with Sapylin. The proliferative, migratory, and angiogenic capacity of HUVEC and HFL1 cells were significantly enhanced after being treated with Sapylin group drainage fluids. CONCLUSION Sapylin could stimulate the body to secrete a variety of cytokines to promote wound healing by promoting endothelial cell proliferation and migration, angiogenesis and by increasing fibroblast migration and collagen deposition.
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Affiliation(s)
- Deguang Kong
- Department of General Surgery, Wuhan University Zhongnan Hospital, 169 Donghu Road, Wuhan, 430071, PR China.
| | - Dan Zhang
- Department of Thyroid and Breast Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, PR China.
| | - Qiuxia Cui
- Department of Thyroid and Breast Surgery, Wuhan University Zhongnan Hospital, 169 Donghu Road, Wuhan, 430071, PR China.
| | - Kun Wang
- Department of Thyroid and Breast Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, PR China.
| | - Jianing Tang
- Department of Thyroid and Breast Surgery, Wuhan University Zhongnan Hospital, 169 Donghu Road, Wuhan, 430071, PR China.
| | - Zhisu Liu
- Department of General Surgery, Wuhan University Zhongnan Hospital, 169 Donghu Road, Wuhan, 430071, PR China.
| | - Gaosong Wu
- Department of Thyroid and Breast Surgery, Wuhan University Zhongnan Hospital, 169 Donghu Road, Wuhan, 430071, PR China.
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Torres Y, Brygo A, Ferri J. A 17-year surgical experience of the intraoral approach for ranulas. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2018; 119:172-176. [PMID: 29501804 DOI: 10.1016/j.jormas.2018.02.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 01/25/2018] [Accepted: 02/21/2018] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The aim of this study was to analyze the clinical features and treatment outcomes in order to determine the optimal management of ranulas in our Oral and Maxillofacial Surgery department with long-term results. PATIENTS AND METHODS A retrospective study was performed to evaluate patients with a final diagnosis of a simple or plunging ranula at Lille Teaching Hospital from May 2000 to January 2017. Clinical data on ranulas that were reviewed included gender, age, symptoms, location of the lesion, surgical procedures, complications, recurrence and follow-up. RESULTS The 26 patients included in the study comprised 18 males and 8 females, ranging from 3-months to 38 years of age. A total of 27 ranulas were managed: 25 oral ranula and 2 plunging ranulas. Twelve patients had undergone marsupialization (44.4%), 7 patients had complete excisions of the ranula (25.9%) or partial excisions combined with marsupialization (14.8%) and 4 patients (14.8%) had undergone excision of the sublingual gland (SLG). Seven ranulas recurred (25.9%). Not a single case recurred following the excision of the SLG. Treatments that included marsupialization were associated with the lowest recurrence rate (16.7%) after SLG excision, followed by combined marsupialization and ranula excision (25%) and by ranula excision alone (57%). There were no major complications. DISCUSSION Long-term outcomes confirm the different surgical procedures available in the outpatient clinic for the management of ranulas based on our surgical experience. Transoral resection of the SLG should be the optimal treatment, producing the lowest recurrence rate.
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Affiliation(s)
- Y Torres
- Department of Oral and Maxillofacial Surgery, Lille Teaching Hospital, Roger Salengro Hospital, Lille Teaching Hospital, 59000 Lille, France.
| | - A Brygo
- Department of Oral and Maxillofacial Surgery, Lille Teaching Hospital, Roger Salengro Hospital, Lille Teaching Hospital, 59000 Lille, France.
| | - J Ferri
- Department of Oral and Maxillofacial Surgery, Lille Teaching Hospital, Roger Salengro Hospital, Lille Teaching Hospital, 59000 Lille, France; Inserm U 1008, Controlled Drug Delivery Systems and Biomaterials, Roger Salengro Hospital, Lille Teaching Hospital, 59000 Lille, France.
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Lyly A, Castrén E, Aronniemi J, Klockars T. Plunging ranula - patient characteristics, treatment, and comparison between different populations. Acta Otolaryngol 2017; 137:1271-1274. [PMID: 28754079 DOI: 10.1080/00016489.2017.1357082] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To review our clinical experience and characteristics of Finnish patients with plunging ranula and compare our results with reports from other populations. DESIGN A retrospective study from the electronic hospital records between 2005 and 2016. SETTING The Department of Otorhinolaryngology and Head and Neck Surgery of Helsinki University Hospital, Finland. RESULTS We describe the characteristics and treatment of 41 patients with MRI-confirmed plunging ranula. Most of our patients were young adults and 88% of them were male. Surgery and sclerotherapy were used for treatment. CONCLUSIONS The vast majority of Finnish plunging ranula patients in our cohort were male, suggesting significant population-related differences in plunging ranula gender distribution. Transoral surgery seemed to result in lowest recurrence rate and was the most common treatment in our clinic.
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Affiliation(s)
- Annina Lyly
- Department of Otorhinolaryngology – Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Eeva Castrén
- Department of Otorhinolaryngology – Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Johanna Aronniemi
- Department of Radiology, HUS Medical Imaging Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Tuomas Klockars
- Department of Otorhinolaryngology – Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Packiri S, Gurunathan D, Selvarasu K. Management of Paediatric Oral Ranula: A Systematic Review. J Clin Diagn Res 2017; 11:ZE06-ZE09. [PMID: 29207849 DOI: 10.7860/jcdr/2017/28498.10622] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 08/29/2017] [Indexed: 11/24/2022]
Abstract
Introduction Ranula is mucous extravasation cyst that occurs in the floor of the mouth. There are various methods of management of paediatric oral ranula each of which has their own advantage and disadvantage. Aim The aim of this paper was to systematically review the available literature on the management of paediatric oral ranula. Materials and Methods A total of 64 articles were retrieved by electronic search. Based on the preset inclusion and exclusion criteria, a total of 21 articles were retrieved for full text analysis. The following characteristics were assessed from the retrieved articles: author, year of publication, study design, sample size, intervention, adverse effects and follow up period. Results The included studies consisted of the following study design: Seven articles were prospective clinical study, four articles were retrospective review, five articles were case series and five articles were case report. The mode of care varied from surgical excision to drug administration and lasers. Conclusion The data obtained from the review, display a lack of high quality study, with proper sample size and adequate follow up period. Further, randomized clinical trials are required to help the clinicians devise a best treatment approach for the management of paediatric oral ranula.
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Affiliation(s)
- Saraniya Packiri
- Postgraduate Student, Department of Paedodontic and Preventive Dentistry, Saveetha Dental College, Chennai, Tamil Nadu, India
| | - Deepa Gurunathan
- Professor, Department of Paedodontic and Preventive Dentistry, Saveetha Dental College, Chennai, Tamil Nadu, India
| | - Kathiravan Selvarasu
- Senior Lecturer, Department of Oral and Maxillofacial Surgery, Saveetha Dental College, Chennai, Tamil Nadu, India
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Ryu KH, Lee JH, Lee JY, Chung SR, Chung MS, Kim HW, Choi YJ, Baek JH. Ethanol Ablation of Ranulas: Short-Term Follow-Up Results and Clinicoradiologic Factors for Successful Outcome. AJNR Am J Neuroradiol 2017; 38:1794-1798. [PMID: 28663262 DOI: 10.3174/ajnr.a5292] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 05/09/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Surgical excision of an affected sublingual gland for treatment of a ranula can carry a potential of a nerve damage or postoperative complications. However, there have been little studies about effective minimally invasive therapeutic method, yet. Our aim was to evaluate the efficacy and safety of ethanol ablation of ranulas and the clinicoradiologic factors that can predict outcome. MATERIALS AND METHODS This retrospective study evaluated 23 patients with ranulas treated by percutaneous ethanol ablation. Treatment outcome was assessed in 20 patients followed for at least 6 months. The duration of symptoms before ethanol ablation, pretreatment volume, and parapharyngeal extension on sonography and/or CT were correlated with the outcome. The Mann-Whitney U test and Fisher exact test were used for comparison of the factors according to the outcome. RESULTS The study evaluated 14 males and 9 females with a median age of 26 years (range, 3-41 years). Among 20 patients who were followed for at least 6 months (median, 20 months; range, 6-73 months), 9 patients (45%) demonstrated complete disappearance of the ranulas and 11 (55%) showed an incomplete response. When the patients were divided according to the duration of symptoms before ethanol ablation, the complete response rate was significantly higher in patients with ≤12 months of symptoms (73%, 8/11) than that in others (11%, 1/9) (P = .010). Pretreatment volume and parapharyngeal extension were not significantly different between the 2 groups. CONCLUSIONS Ethanol ablation is a safe and noninvasive treatment technique for ranulas with a significantly better outcome in patients with ≤12 months of symptoms. Therefore, it could be considered an alternative nonsurgical approach for ranulas with recent onset of symptoms.
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Affiliation(s)
- K H Ryu
- From the Department of Radiology and Research Institute of Radiology (K.H.R., J.H.L., J.Y.L., S.R.C., M.S.C., H.W.K., Y.J.C., J.H.B.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.,Department of Radiology (K.H.R.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - J H Lee
- From the Department of Radiology and Research Institute of Radiology (K.H.R., J.H.L., J.Y.L., S.R.C., M.S.C., H.W.K., Y.J.C., J.H.B.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - J Y Lee
- From the Department of Radiology and Research Institute of Radiology (K.H.R., J.H.L., J.Y.L., S.R.C., M.S.C., H.W.K., Y.J.C., J.H.B.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.,Department of Radiology (J.Y.L.), Soonchunhyang University College of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - S R Chung
- From the Department of Radiology and Research Institute of Radiology (K.H.R., J.H.L., J.Y.L., S.R.C., M.S.C., H.W.K., Y.J.C., J.H.B.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - M S Chung
- From the Department of Radiology and Research Institute of Radiology (K.H.R., J.H.L., J.Y.L., S.R.C., M.S.C., H.W.K., Y.J.C., J.H.B.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.,Department of Radiology (M.S.C.), Chung-Ang University College of Medicine, Chung-Ang University Medical Center, Seoul, Republic of Korea
| | - H W Kim
- From the Department of Radiology and Research Institute of Radiology (K.H.R., J.H.L., J.Y.L., S.R.C., M.S.C., H.W.K., Y.J.C., J.H.B.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Y J Choi
- From the Department of Radiology and Research Institute of Radiology (K.H.R., J.H.L., J.Y.L., S.R.C., M.S.C., H.W.K., Y.J.C., J.H.B.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - J H Baek
- From the Department of Radiology and Research Institute of Radiology (K.H.R., J.H.L., J.Y.L., S.R.C., M.S.C., H.W.K., Y.J.C., J.H.B.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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Prospective comparison of Sapylin and Avitene for reducing hydrops after axillary lymphadenectomy in breast cancer patients. J Surg Res 2017; 210:8-14. [DOI: 10.1016/j.jss.2016.10.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 10/14/2016] [Accepted: 10/28/2016] [Indexed: 11/22/2022]
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Kong D, Liu Y, Li Z, Cui Q, Wang K, Wu K, Wu G. OK-432 (Sapylin) Reduces Seroma Formation After Axillary Lymphadenectomy in Breast Cancer. J INVEST SURG 2016; 30:1-5. [PMID: 27431576 DOI: 10.1080/08941939.2016.1204386] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Purpose/aim: Modified radical mastectomy is the standard surgery for breast cancer in developing countries. However, seroma formation regarded as the most frequent postoperative complication limits the therapeutic benefit of mastectomy and axillary surgery. The purpose of this study was to evaluate the efficacy of OK-432 in reducing seroma formation after axillary dissection. METHODS This prospective cohort study included 80 patients with advanced breast cancer who underwent modified radical mastectomy. Patients were randomized into two groups, which differed with the OK-432 administration. N = 40 patients per group were treated with either OK-432 plus closed suction drainage or drainage-only. RESULT In comparison with the drainage-only group, we found that patients in the OK-432 group had a lower drainage volume (p = .030) and a shorter duration of axillary drainage (p < .01). Besides, the use of OK-432 could reduce the incidence of seroma formation (p < .01) and the volume of seroma (p = .040). There were also significant differences in reducing the chance of evacuative punctures (p = .036) and the healing time (p < .01) between control and OK-432 group. CONCLUSION OK-432 not only shortened the suction drainage duration, but also significantly reduced seroma formation as well as the needs for aspiration punctures after modified radical mastectomy.
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Affiliation(s)
- Deguang Kong
- a Department of Thyroid and Breast Surgery, Tongji Hospital of Tongji Medical College , Huazhong University of Science and Technology , Wuhan , P. R. China
| | - Yu Liu
- b Department of Geriatrics, Tongji Hospital of Tongji Medical College , Huazhong University of Science and Technology , Wuhan , P. R. China
| | - Zhihua Li
- a Department of Thyroid and Breast Surgery, Tongji Hospital of Tongji Medical College , Huazhong University of Science and Technology , Wuhan , P. R. China
| | - Qiuxia Cui
- a Department of Thyroid and Breast Surgery, Tongji Hospital of Tongji Medical College , Huazhong University of Science and Technology , Wuhan , P. R. China
| | - Kun Wang
- a Department of Thyroid and Breast Surgery, Tongji Hospital of Tongji Medical College , Huazhong University of Science and Technology , Wuhan , P. R. China
| | - Kongming Wu
- c Department of Oncology, Tongji Hospital of Tongji Medical College , Huazhong University of Science and Technology , P. R. China
| | - Gaosong Wu
- a Department of Thyroid and Breast Surgery, Tongji Hospital of Tongji Medical College , Huazhong University of Science and Technology , Wuhan , P. R. China
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Zhang B, Yang Z, Zhang RM, Liu L, Zhang F, Chen J, Zhang K. Are the patients with anatomic variation of the sublingual/Wharton's duct system predisposed to ranula formation? Int J Pediatr Otorhinolaryngol 2016; 83:69-73. [PMID: 26968056 DOI: 10.1016/j.ijporl.2016.01.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 01/13/2016] [Accepted: 01/19/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To evaluate ranula development according to anatomic variation of the ductal system of sublingual gland (SLG), especially the presence of Bartholin's duct. METHODS The anatomic variation of SLG duct was prospectively investigated and compared between 55 consecutive patients with ranulas treated by SLG excision (group 1) and another 15 consecutive patients undergoing similar surgeries for other conditions (group 2). The ductal structures of SLGs and submandibular glands (SMG) were also compared between the pediatric patients and adult patients with ranulas. RESULTS In 32 of 55 patients with ranulas (58.2%) and 1 of 15 patients without ranulas (6.7%), the SLG showed an anatomic variation of the main duct called Bartholin's duct structure (P<0.01). Seventeen of 22 (77.3%) pediatric patients with ranulas had Bartholin's ducts and 15 of 33 (45.5%) adult patients with ranulas had Bartholin's ducts (0.01<P<0.05), but Bartholin's duct which opens near to the orifice of Wharton's duct was not found in this study population. Plunging ranulas that extravasate deep to the mylohyoid were observed in the 6 patients (4 children and 2 adults). There was no recurrence in all cases with ranulas. CONCLUSIONS Congenital anatomic variation of the ductal system of the SLG might be a possible cause of ranulas in the patients with simple ranulas, especially in pediatric patients. Surgical resection of the SLG is a better treatment choice for ranulas than other conservative treatments.
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Affiliation(s)
- Bo Zhang
- Department of Oral and Maxillofacial Surgery, Hunan Provincial People's Hospital and The First Affiliated Hospital of Hunan Normal University, Changsha, PR China.
| | - Zongfan Yang
- Department of Oral and Maxillofacial Surgery, Hospital of National University of Defense Technology, Changsha, PR China
| | - Ricardo M Zhang
- Division of International, Hunan Normal University, Changsha, PR China
| | - Li Liu
- Statistical Solutions, Inc. Exton, PA, USA
| | - Feng Zhang
- Department of Physical Therapy, Baltimore City Community College, Baltimore, MD, USA
| | - Jingjing Chen
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, University of Maryland, Baltimore, MD, USA
| | - Ke Zhang
- Department Family and Preventive Medicine, School of Medicine, University of Utah, UT, USA
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Abstract
PURPOSE OF REVIEW Ranula is extravasation mucocele arising from the sublingual gland, influencing the swallowing or eating; this review focuses on the most recent literature pertaining to pediatric ranulas and aims to comprehensively describe the methods of diagnosis and management approaches. RECENT FINDINGS Ranulas consist of intraoral ranula and plunging ranula, which are frequently misdiagnosed, so it is vital for the differential diagnosis of pediatric ranulas to depend on the clinical examination, imaging and fine-needle aspiration cytology. Pediatric patients should first be observed for 6 months before other treatments. OK-432 could activate inflammatory reaction to induce shrinkage of pediatric ranulas. Marsupialization, incision with drainage and ranula excision alone, are associated with a high rate of recurrence, even marsupialization with packing and modified micromarsupialization should be prudently applied for primary treatment of intraoral ranula. Laser excision is considered an alternative treatment for intraoral ranula of pediatric patients because of low recurrence rates and surgical complications. Recently, sublingual gland with or without ranula excision is a reasonable and suitable choice for radical treatment in pediatric patients. SUMMARY The principal goal of pediatric ranula management is radical sublingual gland excision, sealing the mucus extravasates and lowest complications.
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Garofalo S, Mussa A, Mostert M, Suteu L, Vinardi S, Gamba S, Lonati L, Teruzzi E, Tommasoni N, Bassignana M, Masi G, Marenzi G, Sammartino G, Mortellaro C. Successful medical treatment for ranula in children. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 117:e289-97. [DOI: 10.1016/j.oooo.2012.07.430] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Revised: 06/12/2012] [Accepted: 07/10/2012] [Indexed: 10/27/2022]
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18
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Kim JH. Ultrasound-guided sclerotherapy for benign non-thyroid cystic mass in the neck. Ultrasonography 2014; 33:83-90. [PMID: 24936500 PMCID: PMC4058977 DOI: 10.14366/usg.13026] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2013] [Accepted: 01/28/2014] [Indexed: 11/03/2022] Open
Abstract
Surgical excision has traditionally been the treatment of choice for benign non-thyroid cystic neck masses, including lymphatic malformation, ranula, branchial cleft cyst, thyroglossal duct cyst, and parathyroid cyst. However, there is a tendency toward recurrence after surgery, and surgery may be accompanied by complications, including nerve injuries, vascular injuries, and scar formation. Ultrasound-guided sclerotherapy using various agents has been challenged and successfully applied as an alternative treatment for benign non-thyroid cystic neck masses. This report reviews the available sclerosing agents and describes the applications of sclerotherapy to the treatment of benign cystic masses in the neck.
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Affiliation(s)
- Ji-Hoon Kim
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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19
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Kolomvos N, Theologie-Lygidakis N, Tzerbos F, Pavli M, Leventis M, Iatrou I. Surgical treatment of oral and facial soft tissue cystic lesions in children. A retrospective analysis of 60 consecutive cases with literature review. J Craniomaxillofac Surg 2014; 42:392-6. [PMID: 24518363 DOI: 10.1016/j.jcms.2014.01.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 10/22/2013] [Accepted: 01/06/2014] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES To present the experience in the treatment of soft tissue cysts of the orofacial region in children treated at the Department of Oral and Maxillofacial Surgery at Children's Hospital "A. and P. Kyriakou", Dental School, University of Athens. STUDY DESIGN This is a retrospective study including 60 young individuals, 4 months to 14 years old. Surgical treatment was provided under general anaesthesia, during a 13-year period from 2000 to 2012. RESULTS The majority of cysts were mucoceles (n = 36, 60.0%), followed by ranulas (n = 15 or 25.0%), dermoid cysts (n = 4 or 6.6%), branchial cysts (n = 2 or 3.3%), thyroglossal duct cysts (n = 2, 3.3%) and one case of cystic hygroma (n = 1 or 1.6%). The primary method of treatment was enucleation and secondary marsupialization. CONCLUSION It is very important to appreciate that although soft tissue cysts are benign lesions, some of them may grow to a large size and become a major threat, especially in developing orofacial regions in children. In addition, as some types of soft tissue cysts such as cystic hygroma show a tendency to recur, early examination and follow-up is required for the young population.
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Affiliation(s)
- Nikolaos Kolomvos
- University Department of Oral and Maxillofacial Surgery (Head: Prof. C. Alexandridis), at the Children's Hospital "A. and P. Kyriakou" (Director: Prof. I. Iatrou), Dental School, University of Athens, Greece
| | - Nadia Theologie-Lygidakis
- University Department of Oral and Maxillofacial Surgery (Head: Prof. C. Alexandridis), at the Children's Hospital "A. and P. Kyriakou" (Director: Prof. I. Iatrou), Dental School, University of Athens, Greece.
| | - Fotios Tzerbos
- University Department of Oral and Maxillofacial Surgery (Head: Prof. C. Alexandridis), at the Children's Hospital "A. and P. Kyriakou" (Director: Prof. I. Iatrou), Dental School, University of Athens, Greece
| | - Maria Pavli
- University Department of Oral and Maxillofacial Surgery (Head: Prof. C. Alexandridis), at the Children's Hospital "A. and P. Kyriakou" (Director: Prof. I. Iatrou), Dental School, University of Athens, Greece
| | - Minas Leventis
- University Department of Oral and Maxillofacial Surgery (Head: Prof. C. Alexandridis), at the Children's Hospital "A. and P. Kyriakou" (Director: Prof. I. Iatrou), Dental School, University of Athens, Greece
| | - Ioannis Iatrou
- University Department of Oral and Maxillofacial Surgery (Head: Prof. C. Alexandridis), at the Children's Hospital "A. and P. Kyriakou" (Director: Prof. I. Iatrou), Dental School, University of Athens, Greece
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20
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Burnett NP, Dunki-Jacobs EM, Callender GG, Anderson RJ, Scoggins CR, McMasters KM, Martin RCG. Evaluation of alpha-fetoprotein staging system for hepatocellular carcinoma in noncirrhotic patients. Am Surg 2013; 116:e32-6. [PMID: 23816006 DOI: 10.1016/j.oooo.2013.02.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Revised: 02/06/2013] [Accepted: 02/15/2013] [Indexed: 01/12/2023]
Abstract
The Barcelona Clinic Liver Cancer (BCLC) staging classification is commonly used for staging hepatocellular carcinoma (HCC). This system assumes the coexistence of cirrhosis; however, a significant proportion of patients with HCC present without cirrhosis. Recently, an alternative system was proposed that stratifies patients according to alpha-fetoprotein (AFP) level. The aim of this study was to apply the AFP staging system to noncirrhotic patients with HCC and evaluate its ability to predict overall survival (OS). A prospective hepatopancreatobiliary database was reviewed for all patients with a diagnosis of HCC. Patients were staged based on BCLC classification as well as by AFP stage according to four levels: less than 10 ng/mL, 10 to 150 ng/mL, 150 to 500 ng/mL, and greater than 500 ng/mL. Cirrhotic patients were compared with noncirrhotic patients in terms of patient demographics and HCC stage. Kaplan-Meier (KM) analysis of OS was performed for noncirrhotic patients according to BCLC and AFP staging systems. Cirrhotic and noncirrhotic patients differed significantly in terms of median age at presentation (64 vs 70 years, P < 0.001) and gender (76 vs 65% male, P = 0.006). BCLS staging classification did not distinguish between cirrhotics and noncirrhotics (P = 0.733), whereas AFP staging demonstrated a significant difference between the two groups (P < 0.0001). KM analysis of OS for noncirrhotic patients with HCC was significant for both the BCLC and the AFP staging systems (P = 0.003 vs P < 0.0001, respectively). Patients presenting with HCC in the absence of cirrhosis appear to have different characteristics than patients with cirrhosis. Staging according to AFP level is an appropriate predictor of prognosis in noncirrhotic patients with HCC.
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Affiliation(s)
- Nicolas P Burnett
- Division of Surgical Oncology, University of Louisville, Louisville, Kentucky 40206, USA.
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Cai Y, Wang R, Yang S, Zhao Y, Zhao J. Sclerotherapy for the mucoceles of the anterior lingual salivary glands with pingyangmycin. Oral Dis 2013; 20:473-6. [PMID: 23848975 DOI: 10.1111/odi.12155] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Revised: 06/11/2013] [Accepted: 06/19/2013] [Indexed: 01/21/2023]
Affiliation(s)
- Y Cai
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei‐MOST) & Key Laboratory of Oral Biomedical Engineering of Ministry of Education School & Hospital of Stomatology Wuhan University Wuhan China
- Department of Oral and Maxillofacial Surgery School and Hospital of Stomatology Wuhan University Wuhan China
| | - R Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei‐MOST) & Key Laboratory of Oral Biomedical Engineering of Ministry of Education School & Hospital of Stomatology Wuhan University Wuhan China
| | - S‐F Yang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei‐MOST) & Key Laboratory of Oral Biomedical Engineering of Ministry of Education School & Hospital of Stomatology Wuhan University Wuhan China
- Department of Oral and Maxillofacial Surgery School and Hospital of Stomatology Wuhan University Wuhan China
| | - Y‐F Zhao
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei‐MOST) & Key Laboratory of Oral Biomedical Engineering of Ministry of Education School & Hospital of Stomatology Wuhan University Wuhan China
- Department of Oral and Maxillofacial Surgery School and Hospital of Stomatology Wuhan University Wuhan China
| | - J‐H Zhao
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei‐MOST) & Key Laboratory of Oral Biomedical Engineering of Ministry of Education School & Hospital of Stomatology Wuhan University Wuhan China
- Department of Oral and Maxillofacial Surgery School and Hospital of Stomatology Wuhan University Wuhan China
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Mun SJ, Choi HG, Kim H, Park JH, Jung YH, Sung MW, Kim KH. Ductal variation of the sublingual gland: A predisposing factor for ranula formation. Head Neck 2013; 36:540-4. [DOI: 10.1002/hed.23324] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2013] [Indexed: 11/05/2022] Open
Affiliation(s)
- Sue Jean Mun
- Department of Otolaryngology-Head and Neck Surgery; Seoul National University Boramae Hospital
| | - Hyo Geun Choi
- Department of Otolaryngology-Head and Neck Surgery; Seoul National University Boramae Hospital
| | - Heejin Kim
- Department of Otolaryngology-Head and Neck Surgery; Seoul National University College of Medicine; Seoul South Korea
| | - Joo Hyun Park
- Department of Otolaryngology-Head and Neck Surgery; Seoul National University College of Medicine; Seoul South Korea
| | - Young Ho Jung
- Department of Otolaryngology-Head and Neck Surgery; Seoul National University Boramae Hospital
| | - Myung-Whun Sung
- Department of Otolaryngology-Head and Neck Surgery; Seoul National University College of Medicine; Seoul South Korea
| | - Kwang Hyun Kim
- Department of Otolaryngology-Head and Neck Surgery; Seoul National University College of Medicine; Seoul South Korea
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23
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Schiel S, Mayer P, Ehrenfeld M, Probst F. Transoraler Zugang bei sublingualer Tauchranula. HNO 2013; 61:669-72. [DOI: 10.1007/s00106-013-2683-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Piazzetta CM, Torres-Pereira C, Amenábar JM. Micro-marsupialization as an alternative treatment for mucocele in pediatric dentistry. Int J Paediatr Dent 2012; 22:318-23. [PMID: 22092694 DOI: 10.1111/j.1365-263x.2011.01198.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Mucocele is a common oral lesion in children and adolescents. Different techniques have been described for the treatment; however, all of them are invasive. AIM This work studied the efficacy of micro-marsupialization for the treatment for mucoceles in paediatric patients. DESIGN A retrospective review was performed using the clinical records of patients aged between 0 and 18 years with a clinical diagnosis of mucocele. The following data were obtained: age, gender, location and size of the lesion, duration of mucocele development, and type of treatment and its results. RESULTS The mean age of the patients was 11.1 ± 3.95 years. Mucoceles were found in the lower lip (83.7%), buccal mucosa (11.6%), and tongue (4.7%). From the overall cohort of 86 cases, 33 were treated by micro-marsupialization, of which five developed a recurrence that required surgical excision. The other 53 cases were treated by surgical excision, and three of these had recurrent disease. No statistically significant difference was found between the treatment methods. CONCLUSIONS Micro-marsupialization can be used to treat mucoceles in paediatric dentistry. It is simpler to perform, minimally invasive, requires no local infiltration of anaesthesia, has a lower postoperative complications rate, and is well-tolerated by patients.
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Affiliation(s)
- Cleto M Piazzetta
- Post-Graduate Program in Dentistry, Oral Medicine Department, Federal University of Paraná, Curitiba, PR, Brazil
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25
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Harrison JD. Modern management and pathophysiology of ranula: literature review. Head Neck 2011; 32:1310-20. [PMID: 20054853 DOI: 10.1002/hed.21326] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND There is a lack of consensus about the appropriate treatment of ranula. The objective of the present investigation was to produce a scientific basis for treatment. METHODS A review of the relevant literature is interpreted in the light of improved knowledge about the local anatomy and the pathophysiology of the salivary glands. RESULTS The oral and plunging ranulas are cystic extravasation mucoceles that arise from the sublingual gland and usually from a torn duct of Rivinus. The sublingual gland is a spontaneous secretor and the salivary flow is resistant to obstruction, which is caused by fibrosis induced by the extravasation. The submandibular gland is not a spontaneous secretor, is less resistant, and does not give rise to ranulas. CONCLUSIONS Effective treatment is removal of the involved unit of the sublingual gland or inducing sufficient fibrosis to seal the leak through which the mucus extravasates.
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Affiliation(s)
- John D Harrison
- Department of Oral Pathology, King's College London Dental Institute at Guy's, King's College and St Thomas' Hospitals, London, United Kingdom
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26
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Wakasugi-Sato N, Kodama M, Matsuo K, Yamamoto N, Oda M, Ishikawa A, Tanaka T, Seta Y, Habu M, Kokuryo S, Ichimiya H, Miyamoto I, Kito S, Matsumoto-Takeda S, Wakasugi T, Yamashita Y, Yoshioka I, Takahashi T, Tominaga K, Morimoto Y. Advanced clinical usefulness of ultrasonography for diseases in oral and maxillofacial regions. Int J Dent 2010; 2010:639382. [PMID: 20445749 PMCID: PMC2860579 DOI: 10.1155/2010/639382] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2009] [Accepted: 02/02/2010] [Indexed: 12/16/2022] Open
Abstract
Various kinds of diseases may be found in the oral and maxillofacial regions and various modalities may be applied for their diagnosis, including intra-oral radiography, panoramic radiography, ultrasonography, computed tomography, magnetic resonance imaging, and nuclear medicine methods such as positron emission tomography. Of these modalities, ultrasound imaging is easy to use for the detection of noninvasive and soft tissue-related diseases. Doppler ultrasound images taken in the B-mode can provide vascular information associated with the morphology of soft tissues. Thus, ultrasound imaging plays an important role in confirming the diagnosis of many kinds of diseases in such oral and maxillofacial regions as the tongue, lymph nodes, salivary glands, and masticatory muscles. In the present article, we introduce three new applications of ultrasonography: guided fine-needle aspiration, measurement of tongue cancer thickness, and diagnosis of metastasis to cervical lymph nodes.
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Affiliation(s)
- Nao Wakasugi-Sato
- Department of Oral Diagnostic Science, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Masaaki Kodama
- Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Kou Matsuo
- Department of Bioscience, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Noriaki Yamamoto
- Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Masafumi Oda
- Department of Oral Diagnostic Science, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Ayataka Ishikawa
- Department of Bioscience, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Tatsurou Tanaka
- Department of Oral Diagnostic Science, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Yuji Seta
- Department of Bioscience, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Manabu Habu
- Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Shinya Kokuryo
- Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Hisashi Ichimiya
- Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Ikuya Miyamoto
- Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Shinji Kito
- Department of Oral Diagnostic Science, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Shinobu Matsumoto-Takeda
- Department of Oral Diagnostic Science, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Tetsuro Wakasugi
- Department of Otorhinolaryngology, University of Occupational and Environmental Health, Kitakyushu, 807-8555, Japan
| | - Yoshihiro Yamashita
- Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Izumi Yoshioka
- Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Tetsu Takahashi
- Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Kazuhiro Tominaga
- Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Yasuhiro Morimoto
- Department of Oral Diagnostic Science, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
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A retrospective study of ranula in two centres in Malaysia. J Maxillofac Oral Surg 2010; 8:316-9. [PMID: 23139535 DOI: 10.1007/s12663-009-0077-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2009] [Accepted: 11/02/2009] [Indexed: 10/19/2022] Open
Abstract
INTRODUCTION Ranula is a mucous extravasation cyst which occurs as a result of trauma or obstruction of the sublingual or minor salivary gland or the duct itself. PATIENTS AND RESULTS 14 patients were seen at Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur and Hospital Tunku Ampuan Afzan, Kuantan, Malaysia between 2000 to 2006. There were six cases of intra-oral ranula and eight plunging ranula. Twelve patients underwent surgical intervention while two refused surgery. Four patients (33.3%) from those who had surgical intervention returned with recurrence; two (16.7%) had marsupialization and the other two (16.7%) had excision of the pseudocyst intraorally. CONCLUSION Excision and marsupialization remain as the treatment of choice in our centres.
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28
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Seo JH, Park JJ, Kim HY, Jeon SY, Kim JP, Ahn SK, Hur DG, Kim DW, Lee JS. Surgical management of intraoral ranulas in children: an analysis of 17 pediatric cases. Int J Pediatr Otorhinolaryngol 2010; 74:202-5. [PMID: 20005579 DOI: 10.1016/j.ijporl.2009.11.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2009] [Revised: 11/12/2009] [Accepted: 11/20/2009] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The preferred treatment of pediatric intraoral ranulas remains controversial. We present our experience with ranulas at the Gyeongsang National University Hospital and review the literature. METHODS The study involved 17 children under 15 years of age who visited our hospital from 2001 to 2008 and were diagnosed with a ranula exceeding 2 cm in diameter. The age and gender of the patients, the surgical procedures, presurgical observation period, postsurgical follow-up period, and complications of each case were determined. The unruptured specimens were all subjected to detailed pathological analysis. RESULTS The patients were on average 9.3 years and there were 10 girls and 7 boys. Spontaneous resolution was not detected in any of the cases during the presurgical observation period. Indeed, in two cases, the ranula had increased in size. The ranula and sublingual gland (SG) were resected in all cases. The average operation time was 1h. Recurrence and complications were not detected in any of the cases. Pathological analyses revealed that there was no communication of the ranula with the SG in any of the cases. CONCLUSIONS Our experiences suggest that the presurgical observation period need not be longer than 3 months and that the resection of ranulas along with the ipsilateral SG is a safe and effective primary treatment for symptomatic pediatric intraoral ranulas that exceed 2cm in diameter.
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Affiliation(s)
- Ji Hyun Seo
- Department of Pediatrics, Institute of Health Sciences, College of Medicine, Gyeongsang National University, Jinju, South Korea
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Syebele K. Regression of both oral mucocele and parotid swellings, following antiretroviral therapy. Int J Pediatr Otorhinolaryngol 2010; 74:89-92. [PMID: 19879006 DOI: 10.1016/j.ijporl.2009.09.043] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2009] [Revised: 09/25/2009] [Accepted: 09/29/2009] [Indexed: 01/19/2023]
Abstract
HIV-salivary gland associated disease is a well accepted concept in the HIV-related literature. Parotid swellings, especially in its cystic benign lymphoepithelial form, have been largely reported. Oral mucoceles (ranulas) were also associated with HIV in some publications. The exact nature of this link between mucoceles and HIV is still to be clarified. The mainstream treatment of most of parotid pathologies and oral mucoceles remains surgical approach. Strong evidences do, however, exist about lymphopithelial lesions of parotid glands that have been successfully treated with antiretroviral drugs. We present a case of intraoral mucocele, coexisting with bilateral parotid gland lymphoepithelial lesions, on a 2-year-old HIV-positive patient. Both parotid gland swellings and the sublingual mucocele have completely regressed following antiretroviral therapy. No surgical intervention was required. Conversely to benign lymphoepithelial lesions of parotid glands, the regression of oral mucocele on HIV-positive patient, following antiretroviral drugs therapy appears to be a rare phenomenon.
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Affiliation(s)
- Kabunda Syebele
- Oral and Dental hospital, Department of Maxillofacial and Oral Surgery, University of Pretoria, PO Box 1266, Pretoria 0001, South Africa.
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