2. PRESENTED BY
DR MANUPRITA AGRAWAL
M S ENT PGT(FINAL YEAR)
MGM MEDICAL COLLEGE, KISHANGANJ
BIHAR
UNDER THE GUIDANCE OF:
DR ALOKE BOSE MAJUMDER
ASSOCIATE PROF.
3.
4. AIMS AND OBJECTIVES
๏To evaluate the various treatment modalities
for ranula, namely
๏ถTotal surgical excision by transcervical or intraoral
route
๏ถMarsupialisation
๏ถSclerotherapy
๏To determine the most successful treatment
modality in terms of a long term disease free
state
5. MATERIALS AND METHODS
๏ฑ Total number of cases : 7
๏ฑ Injection sclerotherapy : 2
๏ฑ Intraoral marsupialisation : 3
๏ฑ Intraoral excision : 1
๏ฑ Trans cervical excision : 1
Period of study : Oct
2008 to Oct 2010
6. CASE GROUP 1
Initially treated by
multiple injection
sclerotherapy and after
reduction in size, it
was planned for
intraoral excision.
7. CASE GROUP 2
All these
patients
were
treated by
MARSUPIALISATION
only.
8. CASE GROUP 3
All these
patients were
treated with
INTRAORAL EXCISION
11. The Patient
presented with a
soft swelling on
the left side of the
floor of mouth
and SUBMANDIBULAR
region since 3
months.
12. The undersurface
of the tongue shows
bluish cystic
swelling which
swelled up on
compression of the
left submandibular
gland. The
overlying skin was
free from the
swelling and was
non tender. There
was no associated
lymphadenopathy.
13. MRI showing
cystic lesion
on the left
side in the
sublingual
region
extending
into the sub
mental
region,
submandibul
ar region.
25. DISCUSSION
Out of the total treatment modalities for Ranula,
SCLEROTHERAPY only gives partial response by
regressing the cyst volume but no complete
disappearance of the lesion which ultimately
require excision. INTRAORAL
MARSUPIALIZATION is satisfactory but
recurrences do occur between 6weeks to 12 months
with rates as high as 61 to 89%. Although TOTAL
EXCISION of the sublingual salivary gland is ideal
but difficult which can only give long term disease
free survival.
26. REFERENCES
1. Sheng Y.,Zhou J.,Chen Xian-zhi,The First Hospital
of Wuhan,Wuhan 430022;Clinical Analysis of 75
Cases of Ranula,Journal of Oral Science
Research,Feb 2009.
2. Ikarashi T.,Inamura K.,Kimura Y.Kimura,Dept.of
Otolaryngology,Nikonkai Hospital,Japan 1994 ; 114
S511; 196-99
3. Ichimura K., The Journal of Laryngology and
Otology 1996 ; 110 ; 554-56
4. Yoshimura Y.,Obara S.,Kondoh T.,Naitoh S., Journal
of Oral and Maxillofacial Surgery 1995 ; 53:3 ; 280-
82.
5. Tae-Wook Choi,Cha-Kun Oh ; Ear,Nose an Throat
Journal; Health Care Industry,Japan ; Dec 2003