A Brief description on Ranula

1. Mucocele
 Mucus is the exclusive secretory product of the
accessory minor salivary glands and the most
prominent product of the sublingual gland.
 The mechanism for mucus cavity development is
extravasation or retention

2.  Mucoceles, exclusive of the irritation fibroma, are most common of
the benign soft tissue masses in the oral cavity.
 Muco: mucus ,
 coele: cavity.
 When in the oral floor, they are called ranula.

3. Extravasation is the leakage of fluid from the ducts or acini into the
surrounding tissue.
Extra: outside, vasa: vessel
Retention: narrowed ductal opening that cannot adequately accommodate
the exit of saliva produced, leading to ductal dilation and surface swelling.
Less common phenomenon

4.  Consist of a circumscribed cavity in the connective tissue and
submucosa producing an obvious elevation in the mucosa

5.  The majority of the mucoceles result from an extravasation of fluid
into the surrounding tissue after traumatic break in the continuity of
their ducts.
 Lacks a true epithelial lining.

6. Ranula
 Is a term used for
mucoceles that occur
in the floor of the
mouth.
 The name is derived
form the word rana,
because the swelling
may resemble the
translucent
underbelly of the frog.

7.  CONGENITAL
 ACQUIRED
 MAY BE FOUND IN NEWBORN INFANTS

8. ETIOLOGY
 Obstruction of one of the salivary glands.
 Essentially a Retention cyst.
 Spontaneous or results from surgery to the floor of mouth,especially
sub-mandibukar duct relocation.

9.  An Extravasation cyst arising from gland of NUHN or BLANDIN
 Occasionally submandibular gland
 Initially there is a blockage of duct causes retention cyst and with
increased pressure there is rupture of acini leading to extravasation
cyst.

10.  Smooth cystic swelling under the tongue usually to one side.
 Presents as a blue dome shaped swelling in the floor of mouth
(FOM) or transparent with overlying blood vessels.
 They tend to be larger than mucoceles & can fill the FOM &
elevate tongue.

11.  Located lateral to the midline, helping to distinguish it from a
midline dermoid cyst.
 If larger,may affect both breathing and swallowing.

13. Plunging or Cervical Ranula
 Occurs when spilled mucin dissects through the mylohyoid muscle
and produces swelling in the neck.
 Extravasation of mucus occurs behind the confines of the floor of the
mouth through the mylohyoid muscle into the upper neck or sub
mental region
 Soft,Cross Fluctuant,Non tender,Dumb bell shaped swelling in sub
mandibular region.
 Bi-Digitally palpable.

14.  Concomitant FOM swelling may or may not be visible.
 Difficult to distinguish clinically from cystic hygroma
 Can be readily picked up by MRI
 Hygroma has simple epithelial lining,ranula contained by loose
connective tissues.

15. Treatment of Mucoceles
in Lip or Buccal mucosa
 Excision with strict removal of any
projecting peripheral salivary glands
 Avoid injury to other glands during primary
wound closure

16. Treatment
o Simple aspiration or drainage results in high recurrence.
o Both simple and plunging ranula needs excision of cyst wall and
sublingual gland.
o Great care to preserve lingual nerve
o Sometimes ranula presenting in neck may need cervical incision