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Neuroradiol J 2021 Apr 8:19714009211008790. 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 2020 Jun 11:145561320927828. 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

Am J Otolaryngol 2019 Jul - Aug;40(4):612-614. Epub 2019 May 15.

Department of Otolaryngology, Mass. Eye and Ear Infirmary, Harvard Medical School, Boston, MA, United States of America.

Plunging ranulas are most often treated surgically; various surgical approaches may be necessary depending on the unique characteristics of each case. Here, we present the case of a plunging ranula noted on imaging to have a cordlike tether, which was revealed intraoperatively to be the lingual nerve. This case illustrates the importance of preoperative imaging for surgical planning, and when a transcervical approach may be the best choice for plunging ranulas. Read More

ANZ J Surg 2019 11 15;89(11):E533-E535. Epub 2018 Oct 15.

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

Oral Surg Oral Med Oral Pathol Oral Radiol 2019 Jan 9;127(1):77-84. Epub 2018 Sep 9.

Division of Oral and Maxillofacial Radiology, Kyushu Dental University, Kitakyushu, Japan. Electronic address:

Objective: The aim of this study was to evaluate the characteristics of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) values of ranulas. In addition, to elucidate DWI findings and ADC values of other representative masses in and around the floor of the mouth.

Study Design: DWI findings and ADC values in 35 patients with ranulas and 33 patients with other masses were retrospectively reviewed with a central focus on cystic masses or lesions that may have cyst-like components in and around the floor of the mouth based on the diagnosis of each respective disease. Read More

J Family Community Med 2018 Sep-Dec;25(3):217-219

Department ENT, Imam Abdulrahman Bin Faisal Univeristy, College of Medicine, Dammam, Saudi Arabia.

Plunging ranula (PR) is a cystic mass presenting on the lateral side of the neck with or without a history of the usual presentation of an intraoral lesion. "PR" is recognized as an uncommon lesion that has been found predominantly in the third decade of life mostly in males. However, the exact prevalence of "PR" is not yet known. Read More

Am J Otolaryngol 2018 Sep - Oct;39(5):497-500. Epub 2018 May 26.

Department of Otolaryngology, Massachusetts Eye and Ear, Boston, MA 02114, United States; Division of Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, 02114, United States. Electronic address:

Objective: A plunging ranula is a pseudocystic collection of mucin extravasated from the sublingual gland into the floor of mouth and through the mylohyoid muscle into the neck. While the lining of a ranula is non-secreting and resection of the sublingual gland is adequate for simple sublingual mucoceles, many surgeons attempt to address plunging ranulas with extensive transoral and transcervical dissections. We review our experience managing plunging ranulas with intraoral sublingual gland excision and ranula drainage alone. Read More

J Clin Exp Dent 2018 Jan 1;10(1):e92-e95. Epub 2018 Jan 1.

Professor, Department of Oral Pathology and Microbiology, Tamilnadu government Dental College and Hospital, Chennai, India.

The term Ranula is a Latin word meaning frog. It refers to a bluish translucent cystic lesion in the floor of the mouth resembling the underbelly of a frog. Ranulas can be true cysts occurring due to ductal obstruction of the sublingual gland or a minor salivary gland or a pseudocyst as a result of ductal injury leading to extravasation and accumulation of saliva in the surrounding tissues. Read More

J Stomatol Oral Maxillofac Surg 2018 Jun 1;119(3):172-176. Epub 2018 Mar 1.

Department of Oral and Maxillofacial Surgery, Lille Teaching Hospital, Roger Salengro Hospital, Lille Teaching Hospital, 59000 Lille, France; Inserm U 1008, Controlled Drug Delivery Systems and Biomaterials, Roger Salengro Hospital, Lille Teaching Hospital, 59000 Lille, France. Electronic address:

Introduction: The aim of this study was to analyze the clinical features and treatment outcomes in order to determine the optimal management of ranulas in our Oral and Maxillofacial Surgery department with long-term results.

Patients And Methods: A retrospective study was performed to evaluate patients with a final diagnosis of a simple or plunging ranula at Lille Teaching Hospital from May 2000 to January 2017. Clinical data on ranulas that were reviewed included gender, age, symptoms, location of the lesion, surgical procedures, complications, recurrence and follow-up. Read More

Clin Case Rep 2018 01 29;6(1):109-114. Epub 2017 Nov 29.

Oral and Maxillofacial Surgery Unit General Hospital Lagos Island Lagos Nigeria.

Plunging ranulas are rare; report of this condition is particularly limited in our environment. We present case series in children; with all cases having both oral and cervical components. It is important to note this type of presentation of plunging ranula and their appropriate management. Read More

ANZ J Surg 2018 10 21;88(10):1043-1046. Epub 2017 Dec 21.

Department of Otolaryngology and Head and Neck Surgery, Logan Hospital, Logan City, Queensland, Australia.

Background: Plunging ranulas are rare mucous extravasation pseudocysts that arise in the floor of the mouth and pass into the submandibular space of the neck. The aim of this study was to investigate the diagnosis, surgical management and outcomes of patients with a plunging ranula at our institution in South East Queensland over a 10-year period.

Methods: A retrospective analysis of adult patients diagnosed with and treated for plunging ranula between 2006 and 2016 at Logan Hospital was conducted. Read More

ORL J Otorhinolaryngol Relat Spec 2017 29;79(6):306-313. Epub 2017 Nov 29.

Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA.

Background/aims: Plunging ranulas are oral mucoceles that often cannot be visualized directly and thus can be challenging to diagnose and differentiate from other neck lesions. Surgery is the preferred treatment option, but the optimal approach requires careful consideration.

Methods: We report the case of a plunging ranula presenting as an isolated neck mass in a 33-year-old patient. Read More