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The plunging ranula. Pathogenesis, diagnosis and management
J G de Visscher1, K G van der Wal, P L de Vogel
1Dept. of Oral and Maxillofacial Surgery, Medisch Centrum Leeuwarden, The Netherlands.
Summary
Plunging ranulas are neck swellings caused by saliva from the sublingual gland. Surgical excision of the sublingual gland and cyst drainage effectively treats this condition, preventing recurrence.
Area of Science:
- Oral and Maxillofacial Surgery
- Surgical Pathology
Background:
- Ranulas are benign cystic lesions originating from the sublingual salivary gland.
- Two types exist: superficial oral ranulas and deeper plunging ranulas.
Observation:
- Plunging ranulas present as neck swellings, often mistaken for other cervical masses.
- Four cases illustrate plunging ranulas causing upper neck swelling.
Findings:
- The primary cause of plunging ranulas is salivary retention/extravasation from the sublingual gland.
- Recurrence is linked to lack of understanding of the etiology and incomplete treatment.
- Successful management involves ipsilateral sublingual gland excision and intra-oral cyst evacuation.
Implications:
- Accurate diagnosis of plunging ranulas is crucial for appropriate management.
- Conservative surgical approaches focusing on the sublingual gland are effective.
- Extensive neck dissection is unnecessary for plunging ranulas.