Marsupialization of Oral Ranula: a case report and literature review
Keywords:
Ranula, MarsupializationAbstract
Ranula is a mucous filled cavity in the floor of the mouth, that arises due to trauma of the sublingual duct, resulting in extravasation of mucus, or due to obstruction of the duct. Treatments included sublingual gland excision were associated with the lowest recurrence rate, but may carry the potential risk of surgical injury to adjacent structures. Marsupialization is an effective alternative treatment of ranulas, achievable under local anesthesia. The dentist has to consider proper treatment plan together with guardian and patient, inform pros, cons and potential complication of each management. Also, recurrences of the lesions were often seen. Thus, regular follow-up is required.
This article reported a 12-year-old girl complained of a swelling in left floor of her mouth. Clinical examination shows a bluish, dome-shaped, fluctuant swelling. Clinical diagnosis of ranula was made. Marsupialization as the ranula management was accomplished under local anesthesia. There was no sign of recurrence after 32 months of follow-up.
References
1. Neville BW, Damm DD, Allen CM, Chi AC. Oral and maxillofacial pathology. 4th ed. St. Louis:Elsevier;2016.
2. Thomson PJ. Surgical treatment of salivary gland disease. In: Moore UJ, editor. Principles of oral and maxillofacial surgery. 6thed. Oxford:Wiley-Blackwell;2011. p. 299-312.
3. Chi AC, Lambert PR 3rd, Richardson MS, Neville BW. Oral mucoceles: a clinicopathologic review of 1,824 cases, including unusual variants. J Oral Maxillofac Surg 2011;69(4):1086-93.
4. Ghom AG. Textbook of oral medicine. 2nded. St. Louis: Jaypee Brothers Medical Publishers; 2010.
5. Stenhouse D. Salivary gland diseases. In: David W, David S, David L, Andrew JEC, editors. Textbook of general and oral surgery. Edinburgh:Churchill Livingstone; 2003. p. 270-3.
6. Riden K. Key topics in oral and maxillofacial surgery. Oxford: Bios Scientific Publishers; 1998.
7. Wiseman R. Of ranula. In: Wiseman R, editor. Severall chirurgicall treatises. London: E. Flesher and J. Macock; 676. p. 334-5.
8. Fragiskos FD. Surgical treatment of salivary gland lesions. In: Fragiskos FD, editor. Oral surgery. Berlin:Springer;2007. p. 327-36.
9. Sanderson RJ. Salivary gland surgery. In: David W, David S, David L, Andrew JEC, editors. Textbook of general and oral surgery. Edinburgh: Churchill Livingstone;2003. p.110-21.
10. Harrison JD. Modern management and pathophysiology of ranula: literature review. Head Neck 2010;32(10):1310-20.
11. Kokong D, Iduh A, Chukwu I, Mugu J. Ranula: current concept of pathophysiologic basis and surgical management options. World J Surg 2017;41:1476-81.
12. Arunachalam P, Priyadharshini N. Recurrent plunging ranula. J Indian Assoc Pediatr Surg 2010;15(1):36-8.
13. Gupta A, Karjodkar FR. Plunging ranula: a case report. ISRN Dent 2011;2011:806928.
14. Zhao YF, Jia Y, Chen XM, Zhang YF. Clinical review of 580 ranulas. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;98(3):281-7.
15. Bouquet JE. Common oral lesions found during a mass screening examination. J Am Dent Assoc 1986;112:50-7.
16. Brannan ZJ, Lubeley LJ, Sutphen SA, Murakami JW. Percutaneous treatment of ranulas: ultrasound-guided drainage with salivary gland chemical ablation. Pediatr radiol 2019;49:801-7.
17. Premna PR, Rita ZA, Deepa K. Micro-marsupialization of sublingual ranula. IOSR-JDMS 2019;18:67-73.
18. Hernandez-Martin A, Torrelo A. Ranula. N Engl J Med 2012;367:e38.
19. Skoulakis CE, Khaldi L, Serletis D. Semertzidis T. A hemangioma on the floor of mouth presenting as ranula. Ear Nose Throat J 2008;87:628-30.
20. Sulfiana N, Sylvyana M, Tasman A, Lia E. Marsupialization as a ranula management: case report. Int J Med Rev Case Rep 2019;3:458-61.
21. Mufeed A, Sajid R, Ahmed A, Ashir KR. A fluctuant swelling in the floor of mouth. J Odontol Res 2015;3(1):40-3.
22. Nguyen BN, Malone BN, Sidman JD, Barnett RB. Excision of sublingual gland as treatment for ranulas in pediatric patients. Int J Pediatr Otorhinolaryngol 2017;97:154-6.
23. Yang Y, Hong K. Surgical results of the intraoral approach for plunging ranula. Acta Otolaryngol 2014;134:201-5.
24. Sigismund PE, Bozzato A, Schumann M, Koch M, Iro H, Zenk J. Management of Ranula: 9 Years' Clinical Experience in Pediatric and Adult Patients. J Oral Maxillofac Surg 2013;71:538-44.
25. Huang SF, Liao CT, Chin SC, Chen IH. Transoral approach for plunging ranula—10-year experience. Laryngoscope 2010;120(1):53-7.
26. de Visscher JG, van der Wal KG, de Vogel PL. The plunging ranula: pathogenesis, diagnosis and management. J Craniomaxillofac Surg 1989;17:182-5.
27. Davison MJ, Morton RP, Mclvor NP. Plunging ranula: clinical observations. Head Neck 1998;20:63-8.
28. Lee DH, Yoon TM, Lee JK, Lim SC. Treatment outcomes of the intraoral approach for a simple ranula. Oral Surg Oral Med Oral Pathol Oral Radiol 2015;119:e223-5.
29. Zhao YF, Jia J, Jia Y. Complications associated with surgical management of ranulas. J Oral Maxillofac Surg 2005;63(1):51-4.
30. Patel MR, Deal AM, Shockley WW. Oral and plunging ranulas: what is the most effective treatment?. Laryngoscope 2009;119(8):1501-9.
31. Yuca K, Bayram I, Cankaya H, Caksen H, Kiroglu AF, Kiris M. Pediatric intraoral ranulas: an analysis of nine cases. Tohoko J Exp Med 2005;205:151-5.
32. Mohan M, Shetty D, Tripthi, Vakil M. Simple ranula: a case report. Heal Talk 2015;7:17-8.
33. Godhi B, Agarwal N, Verma P, Kumar S. Oral ranula: an insight into paediatric dentistry. The Internet Journal of Dental Science 2013;11:1-6.
34. Ghosh C, Balaji VC, Kar S. Marsupialization of ranula in pediatric patient: a case report. RUJODS 2012;1(2 suppl 1):31-2.
35. Pandit RT, Park AH. Management of pediatric ranula. Otolaryngol Head Neck Surg 2002;127(1):115-8.
36. McGurk M, Eyeson J, Thomas B, Harrison JD. Conservative treatment of oral ranula by excision with minimal excision of the sublingual gland: histological support for a traumatic etiology. J Oral Maxillofac Surg 2008;66:2050-7.
37. Baurmash HD. Marsupialization for treatment of oral ranula: a second look at the procedure. J Oral Maxillofac Surg 1992;50(2):1274-9.
38. Lai JB, Poon CY. Treatment of ranula using carbon dioxide laser - case series report. Int J Oral Maxillofac Surg 2009;38(10):1107-11.
39. Ryu KH, Lee JH, Lee JY, Chung SR, Chung MS, Kim HW, et al. Ethanol ablation of ranulas: short-term follow-up results and clinicoradiologic factors for successful outcome. AJNR Am J Neuroradiol 2017;38:1794–8.
40. Kono M, Satomi T, Abukawa H, Hasegawa O, Watanabe M, Chikazu D. Evaluation of OK-432 injection therapy as possible primary treatment of intraoral ranula. J Oral Maxillofac Surg 2016;75(2):336-42.
41. Chanthree O, Bhongmakapat T, Praneechwatakol P, Chewaruangroj W. Success rate of percutaneous ethanol injection of mucocele [dissertation]. Bankok: Mahidol University; 2011.
42. Fukase S, Ohta N, Inamura K, Aoyagi M. Treatment of ranula with intracystic injection of the streptococcal preparation OK-432. Ann Otol Rhinol Laryngol 2003;112(3):214-20.
43. Matondkar SP, Yavagal C, Mandroli PS. Modified micro-marsupialization as an alternative treatment for the management of ranulas in children. Natl J Maxillofac Surg 2019;10(1):95-7.
44. Chow TL, Chan SW, Lam SH. Ranula successfully treated by botulinum toxin type A: report of 3 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;105(1):41-2.
45. Rho MH, Kim DW, Kwon JS, Lee SW, Sung YS, Song YK, et al. OK-432 sclerotherapy of plunging ranula in 21 patients: it can be a substitute for surgery. Am J Neuroradiol 2006;27(5):1090-5.
46. Morton RP, Bartley JR. Simple sublingual ranulas: pathogenesis and management. J Otolaryngol 1995;24:253-4.
47. Delbem AC, Cunha RF, Vieira AE, Ribeiro LL. Treatment of mucus retention phenomena in children by the micro-marsupialization technique: case reports. Pediatr Dent 2000;22:155-8.
48. Sagari S, Vamsi K, Shah D, Singh V, Patil G, Saawarn S. Micro-marsupialization: A minimally invasive technique for mucocele in children and adolescents. J Indian Soc Pedod Prev Dent 2012;30(3):188-91.
49. Sandrini FA, Sant’ana-Filho M, Rados PV. Ranula management: Suggested modifications in the micro-marsupialization technique. J Oral Maxillofac Surg 2007;65(7):1436-8.
50. Rachana PB, Singh RS, Patil VV. Modified micro-marsupialization in padiatric patients: a minimally invasive technique. SRM J Res Dent Sci 2018;9:83-6.
51. Joseph CA, Davidge-Pitts KJ. Mucous extravasation cysts of the head and neck. S Afr J Surg 1985;23:95-7.
2. Thomson PJ. Surgical treatment of salivary gland disease. In: Moore UJ, editor. Principles of oral and maxillofacial surgery. 6thed. Oxford:Wiley-Blackwell;2011. p. 299-312.
3. Chi AC, Lambert PR 3rd, Richardson MS, Neville BW. Oral mucoceles: a clinicopathologic review of 1,824 cases, including unusual variants. J Oral Maxillofac Surg 2011;69(4):1086-93.
4. Ghom AG. Textbook of oral medicine. 2nded. St. Louis: Jaypee Brothers Medical Publishers; 2010.
5. Stenhouse D. Salivary gland diseases. In: David W, David S, David L, Andrew JEC, editors. Textbook of general and oral surgery. Edinburgh:Churchill Livingstone; 2003. p. 270-3.
6. Riden K. Key topics in oral and maxillofacial surgery. Oxford: Bios Scientific Publishers; 1998.
7. Wiseman R. Of ranula. In: Wiseman R, editor. Severall chirurgicall treatises. London: E. Flesher and J. Macock; 676. p. 334-5.
8. Fragiskos FD. Surgical treatment of salivary gland lesions. In: Fragiskos FD, editor. Oral surgery. Berlin:Springer;2007. p. 327-36.
9. Sanderson RJ. Salivary gland surgery. In: David W, David S, David L, Andrew JEC, editors. Textbook of general and oral surgery. Edinburgh: Churchill Livingstone;2003. p.110-21.
10. Harrison JD. Modern management and pathophysiology of ranula: literature review. Head Neck 2010;32(10):1310-20.
11. Kokong D, Iduh A, Chukwu I, Mugu J. Ranula: current concept of pathophysiologic basis and surgical management options. World J Surg 2017;41:1476-81.
12. Arunachalam P, Priyadharshini N. Recurrent plunging ranula. J Indian Assoc Pediatr Surg 2010;15(1):36-8.
13. Gupta A, Karjodkar FR. Plunging ranula: a case report. ISRN Dent 2011;2011:806928.
14. Zhao YF, Jia Y, Chen XM, Zhang YF. Clinical review of 580 ranulas. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;98(3):281-7.
15. Bouquet JE. Common oral lesions found during a mass screening examination. J Am Dent Assoc 1986;112:50-7.
16. Brannan ZJ, Lubeley LJ, Sutphen SA, Murakami JW. Percutaneous treatment of ranulas: ultrasound-guided drainage with salivary gland chemical ablation. Pediatr radiol 2019;49:801-7.
17. Premna PR, Rita ZA, Deepa K. Micro-marsupialization of sublingual ranula. IOSR-JDMS 2019;18:67-73.
18. Hernandez-Martin A, Torrelo A. Ranula. N Engl J Med 2012;367:e38.
19. Skoulakis CE, Khaldi L, Serletis D. Semertzidis T. A hemangioma on the floor of mouth presenting as ranula. Ear Nose Throat J 2008;87:628-30.
20. Sulfiana N, Sylvyana M, Tasman A, Lia E. Marsupialization as a ranula management: case report. Int J Med Rev Case Rep 2019;3:458-61.
21. Mufeed A, Sajid R, Ahmed A, Ashir KR. A fluctuant swelling in the floor of mouth. J Odontol Res 2015;3(1):40-3.
22. Nguyen BN, Malone BN, Sidman JD, Barnett RB. Excision of sublingual gland as treatment for ranulas in pediatric patients. Int J Pediatr Otorhinolaryngol 2017;97:154-6.
23. Yang Y, Hong K. Surgical results of the intraoral approach for plunging ranula. Acta Otolaryngol 2014;134:201-5.
24. Sigismund PE, Bozzato A, Schumann M, Koch M, Iro H, Zenk J. Management of Ranula: 9 Years' Clinical Experience in Pediatric and Adult Patients. J Oral Maxillofac Surg 2013;71:538-44.
25. Huang SF, Liao CT, Chin SC, Chen IH. Transoral approach for plunging ranula—10-year experience. Laryngoscope 2010;120(1):53-7.
26. de Visscher JG, van der Wal KG, de Vogel PL. The plunging ranula: pathogenesis, diagnosis and management. J Craniomaxillofac Surg 1989;17:182-5.
27. Davison MJ, Morton RP, Mclvor NP. Plunging ranula: clinical observations. Head Neck 1998;20:63-8.
28. Lee DH, Yoon TM, Lee JK, Lim SC. Treatment outcomes of the intraoral approach for a simple ranula. Oral Surg Oral Med Oral Pathol Oral Radiol 2015;119:e223-5.
29. Zhao YF, Jia J, Jia Y. Complications associated with surgical management of ranulas. J Oral Maxillofac Surg 2005;63(1):51-4.
30. Patel MR, Deal AM, Shockley WW. Oral and plunging ranulas: what is the most effective treatment?. Laryngoscope 2009;119(8):1501-9.
31. Yuca K, Bayram I, Cankaya H, Caksen H, Kiroglu AF, Kiris M. Pediatric intraoral ranulas: an analysis of nine cases. Tohoko J Exp Med 2005;205:151-5.
32. Mohan M, Shetty D, Tripthi, Vakil M. Simple ranula: a case report. Heal Talk 2015;7:17-8.
33. Godhi B, Agarwal N, Verma P, Kumar S. Oral ranula: an insight into paediatric dentistry. The Internet Journal of Dental Science 2013;11:1-6.
34. Ghosh C, Balaji VC, Kar S. Marsupialization of ranula in pediatric patient: a case report. RUJODS 2012;1(2 suppl 1):31-2.
35. Pandit RT, Park AH. Management of pediatric ranula. Otolaryngol Head Neck Surg 2002;127(1):115-8.
36. McGurk M, Eyeson J, Thomas B, Harrison JD. Conservative treatment of oral ranula by excision with minimal excision of the sublingual gland: histological support for a traumatic etiology. J Oral Maxillofac Surg 2008;66:2050-7.
37. Baurmash HD. Marsupialization for treatment of oral ranula: a second look at the procedure. J Oral Maxillofac Surg 1992;50(2):1274-9.
38. Lai JB, Poon CY. Treatment of ranula using carbon dioxide laser - case series report. Int J Oral Maxillofac Surg 2009;38(10):1107-11.
39. Ryu KH, Lee JH, Lee JY, Chung SR, Chung MS, Kim HW, et al. Ethanol ablation of ranulas: short-term follow-up results and clinicoradiologic factors for successful outcome. AJNR Am J Neuroradiol 2017;38:1794–8.
40. Kono M, Satomi T, Abukawa H, Hasegawa O, Watanabe M, Chikazu D. Evaluation of OK-432 injection therapy as possible primary treatment of intraoral ranula. J Oral Maxillofac Surg 2016;75(2):336-42.
41. Chanthree O, Bhongmakapat T, Praneechwatakol P, Chewaruangroj W. Success rate of percutaneous ethanol injection of mucocele [dissertation]. Bankok: Mahidol University; 2011.
42. Fukase S, Ohta N, Inamura K, Aoyagi M. Treatment of ranula with intracystic injection of the streptococcal preparation OK-432. Ann Otol Rhinol Laryngol 2003;112(3):214-20.
43. Matondkar SP, Yavagal C, Mandroli PS. Modified micro-marsupialization as an alternative treatment for the management of ranulas in children. Natl J Maxillofac Surg 2019;10(1):95-7.
44. Chow TL, Chan SW, Lam SH. Ranula successfully treated by botulinum toxin type A: report of 3 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;105(1):41-2.
45. Rho MH, Kim DW, Kwon JS, Lee SW, Sung YS, Song YK, et al. OK-432 sclerotherapy of plunging ranula in 21 patients: it can be a substitute for surgery. Am J Neuroradiol 2006;27(5):1090-5.
46. Morton RP, Bartley JR. Simple sublingual ranulas: pathogenesis and management. J Otolaryngol 1995;24:253-4.
47. Delbem AC, Cunha RF, Vieira AE, Ribeiro LL. Treatment of mucus retention phenomena in children by the micro-marsupialization technique: case reports. Pediatr Dent 2000;22:155-8.
48. Sagari S, Vamsi K, Shah D, Singh V, Patil G, Saawarn S. Micro-marsupialization: A minimally invasive technique for mucocele in children and adolescents. J Indian Soc Pedod Prev Dent 2012;30(3):188-91.
49. Sandrini FA, Sant’ana-Filho M, Rados PV. Ranula management: Suggested modifications in the micro-marsupialization technique. J Oral Maxillofac Surg 2007;65(7):1436-8.
50. Rachana PB, Singh RS, Patil VV. Modified micro-marsupialization in padiatric patients: a minimally invasive technique. SRM J Res Dent Sci 2018;9:83-6.
51. Joseph CA, Davidge-Pitts KJ. Mucous extravasation cysts of the head and neck. S Afr J Surg 1985;23:95-7.
Downloads
Published
2019-12-29
How to Cite
1.
วีรนิธาน พ. Marsupialization of Oral Ranula: a case report and literature review. udhhosmj [internet]. 2019 Dec. 29 [cited 2026 Feb. 19];27(3):323-34. available from: https://he02.tci-thaijo.org/index.php/udhhosmj/article/view/233013
Issue
Section
Case Report
License
การละเมิดลิขสิทธิ์ถือเป็นความรับผิดชอบของผู้ส่งบทความโดยตรง
ผลงานที่ได้รับการตีพิมพ์ถือเป็นลิขสิทธิ์ของผู้นิพนธ์ ขอสงวนสิทธิ์มิให้นำเนื้อหา ทัศนะ หรือข้อคิดเห็นใด ๆ ของบทความในวารสารไปเผยแพร่ทางการค้าก่อนได้รับอนุญาตจากกองบรรณาธิการ อย่างเป็นลายลักษณ์อักษร
