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Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy
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Plunging ranula: an unusual multilocular presentation.

M Mabongo, B Buch, S P Ngwenya

    SADJ : Journal of the South African Dental Association = Tydskrif Van Die Suid-Afrikaanse Tandheelkundige Vereniging
    |November 18, 2015
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    Summary
    This summary is machine-generated.

    A large, doughy swelling in the neck, diagnosed as a plunging ranula in an HIV-positive patient, required extensive surgery for complete removal and to prevent recurrence.

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    Area of Science:

    • Oral and Maxillofacial Surgery
    • Sialology
    • HIV Medicine

    Background:

    • Plunging ranulas are rare, benign cystic lesions originating from the sublingual salivary gland.
    • HIV-positive individuals may present with diverse oral manifestations, necessitating comprehensive diagnostic approaches.

    Observation:

    • A 32-year-old HIV-positive male presented with a 3-year history of a large, nontender, doughy left submandibular swelling crossing the midline.
    • The lesion caused significant elevation of the oral floor, impaired salivary flow, and bilateral lymphadenopathy.
    • MRI revealed a multilocular cystic lesion disrupting the mylohyoid muscle; aspirate was positive for salivary amylase.

    Findings:

    • A plunging ranula was provisionally diagnosed based on clinical and aspirate findings.
    • The multilocular nature of the cyst, visualized on MRI, indicated a complex presentation.
    • Surgical excision involved intraoral sublingual gland removal and submandibular dissection for complete cyst removal.

    Implications:

    • This case highlights the importance of advanced imaging (MRI) in diagnosing complex plunging ranulas.
    • Aggressive surgical management, including gland excision, is crucial for preventing recurrence in extensive cases.
    • Management of oral lesions in HIV-positive patients requires a multidisciplinary approach, considering potential systemic influences.