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Laryngoscope 2022 Jun 7. Epub 2022 Jun 7.

Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand.

Objectives: This study describes a technique of measurement for neck cyst amylase content and reviews the experience of a tertiary referral center for cases of suspected plunging ranula.

Methods: A retrospective study was performed at the Manukau Surgical Center in Auckland, New Zealand. Patients with a possible diagnosis of plunging ranula based on clinical presentation and diagnostic aspiration of the cyst contents were included. Read More

Clin Pract 2022 Mar 28;12(2):215-218. Epub 2022 Mar 28.

Division of Otolaryngology, Tohoku Medical and Pharmaceutical University Hospital, 1-12-1, Fukumuro, Miyaginoku, Sendai 983-8512, Japan.

Objectives: Plunging ranula intruding into the cervical region is rare and a standard therapy has not yet been consolidated. This paper investigates the outcomes and side effects of OK-432 treatment in patients with a ranula extending into the cervical region.

Methods: The study design and setting consisted of a planned data collection at Tohoku Medical and Pharmaceutical University and Fukase Clinic. Read More

Cureus 2022 Feb 21;14(2):e22423. Epub 2022 Feb 21.

Pathology, Dharamshila Narayana Superspeciality Hospital, New Delhi, IND.

A plunging ranula is a benign cystic lesion in the neck formed due to mucin extravasated from a salivary gland, most commonly the sublingual gland. Ranulas have been described in association with congenital anomalies, trauma, diseases of the sublingual gland, and HIV; however, rarely, they may result as a complication of various oral and neck surgeries. Here, we report a rare case of plunging ranula that developed in an elderly male as a sequalae to surgery for tongue cancer. Read More

Ear Nose Throat J 2022 Feb 18:1455613221076784. Epub 2022 Feb 18.

Department of Oral and Maxillofacial Surgery/Orthodontics, 218758Yokohama City University Hospital, Yokohama, Japan.

J Craniofac Surg 2022 Feb 4. Epub 2022 Feb 4.

Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Hospital, Yokohama, Kanagawa, Japan.

Abstract: Submandibular gland mucoceles, which are very rare cystic lesions, make differentiation from other cystic neck masses such as plunging ranula and cystic lymphatic malformation difficult. The authors report a rare huge submandibular gland mucocele with diagnostic difficulties. A 39-year-old woman with painless swelling in the left submandibular region underwent OK-432 injection therapy with a diagnosis of plunging ranula at another hospital. Read More

Otolaryngol Head Neck Surg 2021 Dec 21:1945998211067500. Epub 2021 Dec 21.

Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.

Objectives: Plunging ranula is a pseudocyst of saliva extravasated from the sublingual gland (SLG) to the submandibular space. This is treated by transoral excision of the SLG or transcervical cyst excision that might differently affect surgical morbidity and recurrence. This study compared the clinical outcomes of complete vs partial excision of the SLG for plunging ranula. Read More

Am J Otolaryngol 2022 Jan-Feb;43(1):103276. Epub 2021 Nov 3.

Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, England, UK. Electronic address:

Diagnostics (Basel) 2021 Aug 12;11(8). Epub 2021 Aug 12.

Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Eberhard Karls Universität Tübingen, Hoppe-Seyler-Straße 3, 72076 Tuebingen, Germany.

We report the case of a 6-year-old patient with suspected recurrence of a plunging ranula in clinical and ultrasonographic examination. Surgical resection of the left submandibular and sublingual glands had already been performed. Since persistent glandular tissue could not be excluded with certainty via MRI, we expanded diagnostics by performing a PET/MRI using a head and neck imaging protocol and the radiotracer F-PSMA-1007, which is physiologically expressed by salivary gland tissue. Read More

Int J Pediatr Otorhinolaryngol 2021 Sep 23;148:110810. Epub 2021 Jun 23.

State University of Maringa, Mandacaru Avenue, 1550, ZIP CODE 87.083-240, Maringá, PR, Brazil.

Objective: The aim of this article was to conduct a 25-year retrospective study within an oral surgery department, on the incidence of the ranula in children and its ideal treatment, associated with a literature review on the plunging ranula in pediatrics.

Methods: A retrospective review of the medical records of pediatric patients (0-12 years) from 1995 to 2020 was performed in an oral surgery department in Maringá/Brazil. The examined data included age of the patients, sex, clinical signs, time of evolution and follow-up, complementary exams, type of ranula, diagnostic hypothesis, surgical procedures and accesses, complications and recurrence. Read More

Otolaryngol Clin North Am 2021 Jun;54(3):543-551

Department of Otolaryngology, University of Pittsburgh Medical Center, Shadyside Hospital, Suite 211, 5200 Centre Avenue, Pittsburgh, PA 15232, USA. Electronic address:

Mucoceles are common salivary gland disorders. Mucoceles are benign, mucus-filled extravasation pseudocysts that commonly arise on the lower lip of children and young adults. Although surgical excision is commonly performed to remove these lesions, other treatments include marsupialization, micromarsupialization laser ablation, cryotherapy, intralesional steroid injection, and sclerosing agents. Read More

Neuroradiol J 2021 Oct 8;34(5):449-455. Epub 2021 Apr 8.

Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, USA.

Objective: A ranula is a mucus-filled salivary pseudocyst that forms in the floor of the mouth, commonly arising from the sublingual or submandibular salivary glands following obstruction or trauma. Complete excision of the injured gland and removal of the cyst content is the first-choice therapy, but has the potential for complications related to injury to nearby structures. As such, minimally invasive approaches such as percutaneous sclerotherapy have been investigated. Read More

Acta Otolaryngol 2021 May 27;141(5):531-536. Epub 2021 Mar 27.

Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.

Background: Ranula is a rare benign cystic lesion in the floor of the mouth, which can herniate through the mylohyoid muscle and become a plunging ranula. Treatment for ranulas is currently surgical excision of the sublingual gland. Sclerotherapy with OK-432 is a well-established treatment of lymphatic malformations, but not yet thoroughly evaluated on ranulas. Read More

J Med Ultrasound 2020 Oct-Dec;28(4):225-229. Epub 2020 Aug 24.

Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei, Taiwan.

Background: Ultrasound-guided-fine-needle aspiration drainage (US-FNAD) and US-percutaneous ethanol injection (US-PEI) have been widely used in the management of benign neck cysts. However, the long-term results of US-FNAD and US-PEI are not well elucidated.

Methods: We retrospectively collated patients under neck US examinations from March 2007 to December 2017 and investigated the recurrence after US-FNAD and US-PEI. Read More

Afr J Paediatr Surg 2021 Apr-Jun;18(2):106-108

Department of Paediatric Surgery, AIIMS, Raipur, Chhattisgarh, India.

Simple ranula is a cystic swelling confined to the floor of mouth while plunging ranula presents with extension to the neck. Congenital ranula presenting with symptoms of feeding difficulties is a very rare occurrence. There is paucity of literature regarding the management of large congenital ranula. Read More

Oral Maxillofac Surg Clin North Am 2021 May 29;33(2):161-168. Epub 2021 Jan 29.

Atlanta, GA, USA; Oral and Maxillofacial Surgery, Woodhull Hospital, Brooklyn, NY, USA; Mona Dental Program, Faculty of Medicine, University of the West Indies, Kingston, Jamaica. Electronic address:

There are 2 types of ranulas: oral ranulas and plunging (cervical) ranulas. The management of the cervical ranula involves surgical excision of the oral portion of the ranula along with the associated sublingual salivary gland. The sublingual gland is easily removed from an intraoral approach. Read More

Medeni Med J 2020 30;35(3):271-275. Epub 2020 Sep 30.

Universiti Kebangsaan Malaysia Medical Center, Department of Otorhinolaryngology and Head and Neck Surgery, Kuala Lumpur, Malaysia.

Histopathologically adult extracardiac rhabdomyoma is a benign tumour of mature striated muscle. It is a slow- growing tumour with predilection to occur in head and neck region. They appear mainly as a solitary lesion, and about 15% of them can be multicentric. Read More

Ann Maxillofac Surg 2020 Jan-Jun;10(1):258-261. Epub 2020 Jun 8.

Department of Head and Neck Surgery, MMDU, Ambala, Haryana, India.

Epidermoid cysts are abnormal structures originating from abnormal ectoderm and are benign and slow growing. These are found anywhere in the body. They arise during embryonic fusion due to entrapment of epithelial remnants and sometimes due to faulty implantation of the epithelium. Read More

Oral Radiol 2021 Apr 16;37(2):328-335. Epub 2020 Aug 16.

Department of Radiology and Cancer Biology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1, Sakamoto, Nagasaki, 852-8588, Japan.

Juvenile primary Sjögren's syndrome (pSS) is rare. Although recurrent parotitis is reported to be the most common symptom of juvenile pSS, the clinical symptoms and features of the syndrome are not well understood and are poorly defined. Here we report a rare case of juvenile pSS in a patient with plunging ranula. Read More

Ear Nose Throat J 2021 Dec 11;100(10_suppl):1004S-1005S. Epub 2020 Jun 11.

Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Selayang, Batu Caves, Malaysia.

ANZ J Surg 2020 11 21;90(11):E108-E109. Epub 2020 Mar 21.

Department of Ear, Nose and Throat Surgery, Alfred Health, Melbourne, Victoria, Australia.

Laryngoscope 2021 01 28;131(1):73-77. Epub 2020 Feb 28.

Department of Otolaryngology-Head and Neck Surgery, Manukau Surgery Centre, Counties Manukau District Health Board, Auckland, New Zealand.

Objectives: We present a series of bilateral plunging ranula patients to examine the etiology, diagnosis, treatment, and prognosis of this condition.

Methods: A retrospective chart review was performed on all cases of plunging ranula treated at the Department of Otolaryngology-Head and Neck Surgery, Counties Manukau District Health Board, New Zealand, between 2001 and 2019.

Results: There were 17 patients with bilateral plunging ranulas from a total of 187 plunging ranula patients. Read More

Am J Otolaryngol 2020 May - Jun;41(3):102418. Epub 2020 Feb 7.

Department of Otolaryngology, Texas Children's Hospital, 6621 Fannin Street, Houston, TX 77030, United States of America.

Purpose: Investigate the efficacy of sublingual gland removal for the treatment of simple and plunging ranulas.

Materials And Methods: After IRB approval, a retrospective review was performed on patients treated for a ranula from February 2013 to May 2018 at Texas Children's Hospital in Houston, TX. Clinical data was collected from medical records and patients were contacted in November 2018 to obtain additional information about recurrences or complications. Read More

Beijing Da Xue Xue Bao Yi Xue Ban 2020 Feb;52(1):193-195

Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.

Plunging ranula is rare and manifests as the submandibular or submental cystic mass, without intra-oral abnormality. It usually causes misdiagnosis and malpractice. This article reported a case of plunging ranula that appeared as a massive mass located behind the left ear. Read More

J Korean Assoc Oral Maxillofac Surg 2019 Dec 26;45(6):357-363. Epub 2019 Dec 26.

Department of Oral and Maxillofacial Surgery, College of Dentistry, Wonkwang University, Iksan, Korea.

Ranula is a mucocele caused by extravasation of the sublingual gland on the floor of the mouth. The most common presentation is a cystic mass in the floor of the mouth. A portion of the sublingual gland could herniate through the mylohyoid muscle, and its extravasated mucin can spread along this hiatus into submandibular and submental spaces and cause cervical swelling. Read More

Int J Clin Exp Pathol 2019 1;12(12):4303-4308. Epub 2019 Dec 1.

Department of Anatomy, Chonnam National University Medical School Gwangju, South Korea.

Objectives/hypothesis: The purpose of this study was to document histologic features of the herniated sublingual gland (SLG) and investigate the histologic correlation between herniated SLG and plunging ranula.

Methods: One hundred half-heads from 50 adult cadavers (21 females and 29 males) were included in this study. The presence of SLG herniation and the histologic features SLG were analyzed. Read More

Am J Otolaryngol 2020 Mar - Apr;41(2):102371. Epub 2019 Dec 20.

Department of MaxilloFacial and Oral Surgery, Sefako Makgatho Health Sciences University, P.O. Box D22, Medunsa 0204, South Africa. Electronic address:

Purpose: The aim of this study was to illustrate and confirm that the complete intraoral excision of the sublingual gland alone, is anatomically the most rational approach, for the management of plunging ranula.

Material And Methods: We retrospectively reviewed clinical charts of diagnosed HIV-infected patients presenting with plunging ranula. The intraoral approach was used for the complete excision of the sublingual gland with evacuation of the pseudocystic content only. Read More

J Ultrasound Med 2020 Feb 23;39(2):273-278. Epub 2019 Jul 23.

Middlemore Hospital, Counties Maukau, Auckland, New Zealand.

Objectives: Plunging (or diving) ranulas are extravasation pseudocysts arising from the sublingual gland that present as soft submandibular swelling. The "tail sign" has been widely reported as pathognomonic for their diagnosis. It is described as a smooth tapering comet-shaped unilocular fluid mass with its "tail" in the collapsed sublingual space (SLS) and its "head" in the posterior submandibular space. Read More

Br J Oral Maxillofac Surg 2019 10 30;57(8):729-733. Epub 2019 Jun 30.

Department of Oral and Maxillofacial Surgery, Lanzhou University Second Hospital, Lanzhou, China. Electronic address:

Neck masses in children are a common clinical concern but there is a paucity of published information about them. We organised this retrospective study to analyse their prevalence and treatment in Northwest China. The records of 207 children who presented with neck masses between 2008 and 2017 were retrieved from the Department of Oral and Maxillofacial Surgery, Lanzhou University Second Hospital, and age, sex, clinical presentation, preoperative investigation, surgical procedure, histopathological diagnosis, and complications were recorded. Read More

Br J Oral Maxillofac Surg 2019 09 22;57(7):620-626. Epub 2019 Jun 22.

Department of Otorhinolaryngology-Head and Neck Surgery, Dongguk University Ilsan Hospital, Goyang, Korea; Sensory Organ Research Institute, College of Medicine, Dongguk University, Gyengju, South Korea. Electronic address:

Treatment for ranula is classified into three categories depending on how the leaking saliva is managed: removal of the leaking site by intraoral or transcervical resection of the sublingual gland; formation of a drainage tract through the wall of the pseudocyst by micromarsupialisation or marsupialisation; or sealing of the site of the leak by inducing fibrosis with a sclerosing agent. Resection of the sublingual gland is probably the option most likely to be curative for both oral and plunging ranula considering their pathophysiology. Although alternative treatments have been introduced to avoid the invasiveness of resection of the gland, their outcomes have been inconsistent. Read More