Surgical treatment of plunging ranula: Report of three cases and review of literature

Abstract

Introduction: Plunging ranulas arise when a simple ranula extends beyond the floor of the mouth into the neck. These cysts usually arise from the sublingual salivary gland and rarely from the submandibular gland. They are either the result of mucus retention or they represent a mucus escape reaction occurring from disruption of the sublingual duct because of local trauma. Two variants have been described in the literature: a simple oral ranula and the deep diving or plunging ranula. A number of different modalities have been described for the treatment of ranulas and especially for plunging ranula. Purpose: The aim of this study is to present the experience of surgical management in three cases of patients with plunging ranula using an extra-oral extension. In addition, clinical and radiographic findings of the patients along with the relevant review of the literature also refered. Cases reports: Three cases of patients with specific diagnosis of plunging ranulas were treated by a cervical approach and excision of the cyst without any intraoral extension. Data of patients were recorded including gender and age, location of lesion and possible treatment. Results: All cysts were ranulas and the cases presented indicate that this lesion can be managed by a less invasive procedure without complications and recurrence. At the first patient ranula grow to a large size and the treatment became by removal of the ipsilateral sublingual and submandibular glands, while at second and third patient by removal of sublingual gland only. Conclusion: There is a consensus about the appropriate treatment of ranula. The best treatment for a plunging ranula is excision of the lesion along with the involved gland (usually sublingual gland). Keywords: Soft tissue cysts, Ranula, Treatment