Treatment of Ranula (Simple or Plunging) Presenting on the Floor of the Mouth
Clinical Scenario
Ranulas are a subset of oral mucocele that present on the floor of the mouth as painless, fluctuant, blue-hued, mobile masses. They may be classified as simple (confined to the oral floor) or plunging (extending beyond the mylohyoid muscle into the neck).
Approach
Management involves either a surgical or injection-based approach targeting the lesion and its underlying source. The choice of intervention depends on the extent and character of the ranula.
The complete regimen — including preferred procedure, technical considerations, and the sclerosing therapy protocol — is available in the full structured protocol below.
References
DOI: 10.1016/j.otc.2021.03.002
- Ranulas are a subset of mucocele that present on the floor of the mouth as painless, fluctuant, blue-hued, mobile masses.
- Superficial and plunging ranulas should be treated with surgical removal of the ranula and implicated sublingual gland via a transoral approach.
- Sublingual gland excision is preferred to marsupialization because of much lower rates of ranula recurrence.
- Plunging ranulas can be effectively treated by removing the sublingual gland transorally and evacuating the extravasated mucus through the transoral approach.
- Kono and colleagues conducted a retrospective chart review including 23 patients with intraoral ranulas treated with OK-432 (picibanil) injection sclerosing therapy.
- More than 1 injection is required in most patients for complete cure.
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