Retrospective analysis of patient records was performed for a series of 95 consecutive cases of plunging ranula. Ranulas are rare, benign, acquired, cystic lesions that occur at the floor of the mouth as sublingual or minor salivary gland retention cysts. Sep 12, 2019 when the ranula recurs, the path of least resistance is through a dehiscent mylohyoid, and a plunging ranula forms when only a simple ranula was present initially. Recognizing the basics pdf, epub, docx and torrent then this site is not for you.
It describes the cystic space beneath the tongue being like the pouchunderbelly of a frog. The term ranula is derived from the latin word rana, meaning frog, and describes a blue, translucent swelling in the floor of the mouth reminiscent of the underbelly of a frog. Aug 28, 2017 sometimes, the cause of a ranula is unknown and the swelling occurs spontaneously. The first one was a plunging ranula attached to my submaxillary salivary gland and was about the size of a golf ball.
Injection of scelorosing agents have been used to induce inflammation and fibrosis from within the lumen of the cyst thus sealing further extravasation. The mri signal within it is typically high on t2weighted images due to the mucin content. The management of a submandibular gland mucocele is potentially controversial and includes a number of treatment modalities that have been advocated in the management of the cervical or plunging ranula. Ct scan shows a large mucous retention cyst arising from the sublingual gland ranula. Deepthi gulivindala the dental clinic, hyderabad, india abstract oral ranula is a retention cyst arising from the sublingual gland on the floor of the mouth as a result of ductal obstruction and fluid retention. Occasionally, diving ranulas may attain large dimensions giant ranula. Ranula is a clinical variant of mucocele and presents as a swelling in the floor of the mouth. Plunging ranula now antiquated treatment see comments. Here are instructions about radiology cases and spotters. Plunging ranulas, also known as deep, diving, cervical or deep plunging ranula, usually appear in conjunction with oral ranula.
If youre looking for a free download links of learning radiology. The fluid within a ranula closely resembles that of the normal secretions of the sublingual glands 5. A ranula usually presents as a translucent, blue, domeshaped, fluctuant swelling in the tissues of the floor of the mouth. The term ranula is used because this lesion often resembles the swollen abdomen of a frog. Recognizing the basics with student consult online access. Various authors have described marsupialization, including jacobson, who provided the first description in 1950 for. If it is deeper it does not have this bluish appearance. Radcases and aunt minnies atlas and imagingspecific diagnosis. Fluid from the obstructed gland dissects between the fascial planes and muscle of the base of the tongue to the submandibular space. Plunging ranula now antiquated treatment see comments about.
If small and asymptomatic further treatment may not be needed, otherwise minor oral surgery may be. The most possible origen of a ranula is the retention or extravasation of saliva from the sublingual gland. Ranula article about ranula by the free dictionary. The exact prevalence of plunging ranula is not known, however, these lesions are considered uncommon. The term ranula was derived from the latin word rana, meaning frog and ranula describing a little frog, denoting its resemblance to a bulging frogs underbelly. The key to diagnosing a ranula, especially in cases where they are large and have dissected some distance away from their origin, is the identification of a connection to the sublingual space. Weight bearing cone beam computed tomography wbct in the foot and ankle. Given the shortage of time, a radiology resident needs to carefully choose what books he should to read. Radiology videos from other websites with important teaching points highlighted. Ranula is a rare benign acquired cystic lesion that occurs at the floor of the mouth. A simple ranula is the most typical form of ranula. Pdf this article discusses ranula, its etiopathogenesis and management options. Department of radiology, catholic university, italy. If the lesion is deeper, then there is a greater thickness of tissue separating from the oral cavity and the blue translucent appearance may not be a feature.
To highlight the current scientific basis of ranula development that informed the preferred surgical approach. It represents a mucocele in the floor of the mouth. We present one such case of the said lesion where the clinical presentation and management were found to be interesting, hitherto unreported in the medical literature. Plunging ranulas are pseudocysts partially contained by the remaining epithelium and inflammatory cells that react to irritative saliva.
Oral ranulas are due to mucus that pools above a muscle in the neck called the mylohyoid. A cyst on the underside of the tongue caused by the obstruction of a duct of a salivary gland. This very large version of the typical diving ranula can be difficult to differentiate from cystic hygroma in this area on the basis of clinical and radiologic findings. Cohen, in pediatric dermatology fourth edition, 20. Ranula is a clinical term for a mucocele or mucous retention cyst located on the floor of the mouth and arises from trauma to the sublingual or submandibular salivary glands fig. A ranula is a mucus extravasation cyst involving a sublingual gland and is a type of mucocele found on the floor of the mouth. Chapter 30 discusses the aetiology and management of the salivary ranula, and that it is possible to manage ranula in a more conservative fashion, especially the plunging ranula. There are case reports of congenital ranula noted on prenatal ultrasound. Ranulas present as a swelling of connective tissue consisting of collected mucin from a rupturedsalivary gland duct, which is usually caused by local trauma. They are most common in the second decade of life and in females. Aetiology and management of the salivary ranula oxford. There is no consensus opinion on a definitive surgical management option for ranulas to curtail recurrence, largely from the existing gap in knowledge on the pathophysiologic basis. Join our telegram group and channel for more radiology cases.
The second was just like you describe, sublingual ranula. The term ranula is derived from the latin word for frog. These lesions can be acquired or congenital, and most are unilateral, although they can rarely be bilateral. Treatment outcomes of the intraoral approach for a simple ranula. Ok432 sclerotherapy of plunging ranula is a safe and potentially curative procedure that may be used as a primary treatment for plunging ranula before considering surgery. Excision of the ipsilateral sublingual gland along with the ranula has been demonstrated to be the most definitive treatment with the lowest rate of recurrence. Current procedural terminology marsupialization of. Fluid from the obstructed gland dissects between the fascial planes and muscle of the base of the tongue to the submandibular triangle. Pdf learning radiology download full pdf book download. Occur when the simple ranula ruptures and is walled off by an inflammatory response.
A secondary otolaryngology service was used as the setting. A ranula is a type of mucocele found on the floor of the mouth. Plunging ranulas usually extend below the level of the mylohyoid. The process is similar in nature to mucocele formation, but ranula involves obstruction of a major rather than minor salivary gland. In other cases, ranulas occur after trauma to the floor of. There is no indication to enter the neck and remove either the sac or the smg. Radiology is a vast subject and there are tons of books available. It has been reported from 2 to 61 years of age with a slight female preponderance. The primary reason for surgery on the sublingual gland is a ranula. Aetiology and management of the salivary ranula oxford medicine. Sublingual means the cyst is confined to the area below or beneath the tongue.
Ranula develops from extravasation of mucus after trauma to the sublingual gland or obstruction of the ducts. A radiology cases quiz consisting of 10 radiology cases on plain films. Cardiac radiology genitourinary radiology learning radiology. For a simple ranula, the mass is contained in the sublingual space. Treatment outcomes of the intraoral approach for a simple. There are lots of resources available on the internet, including articles, case collections, and e books. In most cases mouth cysts are painless, but the mass may be large enough to interfere with eating, chewing and swallowing. Ranula in floor of mouth a plunging ranula extends into the submandibular triangle of the neck through a defect in the mylohyoid muscle, or less commonly, by passing behind the posterior edge of the muscle figure 2.
The most common presentation of ranula is a painless, slowgrowing, soft, and moveble mass located in the floor of the mouth. The american heritage medical dictionary defines marsupialization as a surgical alteration of a cyst or similar enclosed cavity by making an incision and suturing the flaps to the adjacent tissue, creating a pouch. Mucus retention cyst that occurs in the sublingual gland. Radiology books download thousands of radiology books pdf.
Rarely, these ranulas may arise independent of oral swelling. Sometimes, the cause of a ranula is unknown and the swelling occurs spontaneously. Sep 08, 2010 a plunging ranula is an extravasation of saliva from the sublingual gland due to trauma or obstruction of the duct. General instructions for spotters the recommended book for spotters. Up to 44% of all plunging ranulas are iatrogenically induced in this manner. As with all doctors, radiology trainees should never stop learning and. This process is experimental and the keywords may be updated as the learning algorithm improves. Mucus extravasation cyst involving a sublingual gland.
Retrospective analysis of patient records was performed for a series of 95. Treatment of ranula with intracystic injecton of the streptococcal preparation ok432. Normal imaging anatomy modules learn and revise imaging anatomy. The term ranula describes the blue, translucent swelling in the floor of mouth.
A ranula is a mucous cyst found on the floor of the mouth. Recognizing the basics, 2nd edition, is an imagefilled, practical, and clinical introduction to this integral part of the diagnostic process. Radcases and aunt minnies atlas and imaging specific diagnosis. Ranula definition of ranula by the free dictionary. Giant ranula can be defined as any ranula that significantly involves the parapharyngeal space in addition to the submandibular space. Boyd described ranula as a dilatation of the duct of. Congenital ranula in a neonate is an uncommon occurrence. A ranula, or mouth cyst, is indicated by blue swelling under the tongue. A case report of ranula treated with marsupialization and low level laser therapy dr. Radiology cases quiz consisting of 10 radiology spotters. A plunging ranula is an extravasation of saliva from the sublingual gland due to trauma or obstruction of the duct.
William herring, md, a skilled radiology teacher, masterfully covers everything you need to know to effectively interpret medical images. As diving ranula and cystic hygroma are managed with different surgical approaches, avoidance of this pitfall is critical. The differential diagnosis included ranula salivary gland pseudocyst, cephalocele, hygroma, or epignathusa teratoma arising from the soft palate or facial bones. A case report of ranula treated with marsupialization and. A ranula is a benign, mucouscontaining cyst of the sublingual salivary gland that is caused by either rupture or blockade of the salivary duct. A case report of ranula treated with marsupialization and low. A plunging ranula is a cystic mass in the submandibular area arising from an occluded sublingual gland.
An oral ranula is a fluctuant swelling with a bluish translucent color that somewhat resembles the underbelly of a frog rana. As diving ranula and cystic hygroma are managed with different surgical approaches, avoidance. The lesions most often appear early in a patients life, ie, in the first, second, or third decade. Ranula definition is a cyst formed under the tongue by obstruction of a gland duct. Most frequently it stems from the sublingual salivary gland. Cystic lymphangioma and plunging ranula treated by ok432 therapy. Sign up for your own profile on github, the best place to host code, manage projects, and build software alongside 40 million developers. Ranula a ranula latin word rana, meaning frog describes a blue, translucent swelling in the floor of the mouth, reminiscent of the underbelly of a frog.
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