Ranula

Aetiology

• Congenital
• Acquired
  • Oral trauma
  • Surgery

Pathophysiology

• Pseudocysts associated with the sublingual glands and submandibular ducts
• No true cyst wall

Presentation

• Blue, fluctuant swellings lateral to the midline in the lower mouth
• Large ranulas can present as neck masses if they extend through the mylohyoid musculature of the floor of the mouth ('plunging ranula')

Management

• Complete excision is not necessary
• Trans-oral removal of the sub-lingual gland is effective
• Alternatives:
  • Marsupialization
  • Resection of only the anterior half of the gland, which is the usual source of ranulas