THROAT - Ranula

What is ranula?

 Is a cystic swelling in the floor of the mouth.

The term Ranula is derived from the Latin word Rana meaning frog
belly. The cyst looks like belly of a frog.

Theories :
1)      These are retention cysts in relation to mucous secreting glands      of the           sublingual mucous membrane. (Glands of Blandin and Nuhn).
2)      Retention cysts in relation to sublingual salivary glands.
3)      The plunging variety may be due to a forward prolongation of an un-      obliterated part of cervical sinus.

Types:
A. Simple
B. Plunging: (complex, deep)

A.      Simple ranula is relatively localized and is a superficial dilated segment   of a blocked or damaged sublingual gland duct.

B.      Plunging (complex) : Results from extension of oral variety or from the escape of mucus from a posterior sublingual gland which burrows along        the posterior margin of mylohyoid down
into submandibular region to form a cervical swelling.

What are the clinical features of  ranula?

1)      Found in childhood
2)      Situated on one side of frenum linguae either on the floor mouth, or under         surface of tongue. A big cyst may encroach the other side of the floor of     mouth deep to frenum linguae
3)      Mucous membrane is freely mobile on the cyst
4)      Cyst is bluish in colour
5)      Brilliantly transilluminant. Presence of white strands amidst reddish glow           indicating presence of deep lingual veins along the wall, cyst or harton's duct.

 

What is the pathology of ranula?

a)       The wall is lined by epithelium (cuboidal, columnar, and ciliated) or by    fibrous tissue.
b)      Fluid is jelly like and colorless

What is the treatment of ranula?

1)      Total excision :This is ideal but difficult as the cyst almost always bursts          on dissection.
2)      Partial excision with Marsupialisation : This technique prevents     recurrence.
3)      Plunging has to be approached from neck, dissection carried between
mylohyoids.

What are complications of ranula?
1)      Repeated trauma
2)      Bursting of the cyst.
3)      Infections.
4)      Problems in speech and mastication.
5)      Damage to the Wharton’s duct

What is Differential Diagnosis of ranula?

1)      Sublingual dermoid
2)      Hemangioma




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