Document Detail

Oral and plunging ranulas: What is the most effective treatment?
MedLine Citation:
PMID:  19504549     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES/HYPOTHESIS: Preferred treatment of oral/plunging ranulas remains controversial. We present our experience with ranulas at the University of North Carolina (UNC) and review the literature.
METHODS: Retrospective review. From 1990 to 2007, 16 oral ranulas and 10 plunging ranulas were treated at UNC. Combining the UNC series with the literature identified 864 cases for review. An online survey was conducted to identify current treatment patterns.
RESULTS: In the UNC series, procedures for oral ranulas varied from ranula excision (50%), combined ranula and sublingual gland excision (44%), excision of the ranula along with the sublingual gland and submandibular gland (6%). A cervical approach was used in nine plunging ranula cases. One case was treated transorally with sublingual gland removal and evacuation of the ranula. Otherwise, the plunging ranula was removed along with the sublingual gland (20%), submandibular gland (50%), or both (20%). One hundred fifty-one complications were identified from the literature. Recurrence was considered a complication and was most prevalent (63%). Nonrecurrent complications included tongue hypesthesia (26%), bleeding/hematoma (7%), postoperative infection (3%), and Wharton's duct injury (1%). Sublingual gland excision yielded the fewest complications (3%). Procedures and associated complication rates were: transoral excision of sublingual gland (3%); transoral excision of sublingual gland and ranula (12%); marsupialization (24%); transcervical excision of sublingual gland, submandibular gland, and ranula (33%); OK-432 (49%); and aspiration (82%).
CONCLUSIONS: Based on our review, definitive treatment yielding lowest recurrence and complication rates for all ranulas is transoral excision of the ipsilateral sublingual gland with ranula evacuation.
Mihir R Patel; Allison M Deal; William W Shockley
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  The Laryngoscope     Volume:  119     ISSN:  1531-4995     ISO Abbreviation:  Laryngoscope     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-29     Completed Date:  2009-08-28     Revised Date:  2012-05-15    
Medline Journal Info:
Nlm Unique ID:  8607378     Medline TA:  Laryngoscope     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1501-9     Citation Subset:  IM    
Department of Otolaryngology/Head and Neck Surgery, University of North Carolina Hospitals, Chapel Hill, 27599, USA.
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MeSH Terms
Child, Preschool
Cohort Studies
Follow-Up Studies
Middle Aged
Oral Surgical Procedures / adverse effects,  methods*
Postoperative Complications / pathology,  surgery
Ranula / epidemiology,  pathology*,  surgery*
Retrospective Studies
Risk Assessment
Sublingual Gland / pathology,  surgery*
Submandibular Gland / pathology,  surgery*
Surgical Procedures, Minimally Invasive / adverse effects,  methods
Treatment Outcome
Young Adult
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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