Bilateral plunging ranula: two case reports and a review of the literature

Presentation of two bilateral plunging ranula cases and then review of the plunging ranula literature to understand current concepts on aetiology, imaging for diagnosis and management.

A literature review using PubMed (92 papers) and Google Scholar (18 papers) has revealed only 18 cases of bilateral plunging ranulas ever published and with the addition of the two cases presented this makes a total of 20.

These cases are reviewed and information related to aetiology and management is presented. The cause appears to be a combination of mylohyoid dehiscence, racial predisposition and previous trauma to the mouth/face or previous oral surgery.

Plunging ranula are a rare cause of bilateral and unilateral neck swellings but more common in Maori, Polynesian and Asian people. Their cause is multifactorial and ultrasound scan (USS) is the current investigation of choice. Management relies on excision of the sublingual gland with the cystic contents via a trans-oral approach.