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MARSUPIALIZATION OF RANULA

조대술을 시행한 하마종의 치료

  • Na, Hye-Jin (Department of Pediatric Dentistry, College of Dentistry, Yonsei University) ;
  • Lee, Jae-Ho (Department of Pediatric Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University) ;
  • Kim, Seong-Oh (Department of Pediatric Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University) ;
  • Song, Je-Seon (Department of Pediatric Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University) ;
  • Kim, Seung-Hye (Department of Pediatric Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University) ;
  • Choi, Hyung-Jun (Department of Pediatric Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University) ;
  • Choi, Byung-Jai (Department of Pediatric Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University)
  • 나혜진 (연세대학교 치과대학 소아치과학교실) ;
  • 이제호 (연세대학교 치과대학 소아치과학교실 및 구강과학연구소) ;
  • 김성오 (연세대학교 치과대학 소아치과학교실 및 구강과학연구소) ;
  • 송제선 (연세대학교 치과대학 소아치과학교실 및 구강과학연구소) ;
  • 김승혜 (연세대학교 치과대학 소아치과학교실 및 구강과학연구소) ;
  • 최형준 (연세대학교 치과대학 소아치과학교실 및 구강과학연구소) ;
  • 최병재 (연세대학교 치과대학 소아치과학교실 및 구강과학연구소)
  • Received : 2010.11.20
  • Accepted : 2011.01.10
  • Published : 2011.02.28

Abstract

Ranula is a mucosal cyst that occurs in the mouth floor. This is a pseudo cyst caused by mucous retention within the tissue due to the rupture of catheter in the salivary gland. Ranula occurs mainly in a unilateral form and is characterized by painless bluish transparent swelling, with a increasing mass size. If the size is large, it can cause discomfort during swallowing, pronounciation, and mastication, but external swelling and infection is rare. Treatments include observation for spontaneous resolution, simple incision and drainage, marsupialization and excision. Marsupialization done by removing parts of the cyst wall and connecting it to the oral mucosa. It is a conservative procedure and recommended for children. It has advantages such as maintaining outline of oral tissue and less risk of damaging anatomic structure. Recurrence is common, mostly occurring within 4 months after surgery. This case is about a eight-year-old girl with ranula on the right mouth floor. This patient was treated with marsupialization that is one of treatment for ranula, and recurrence was not observed.

하마종은 구강저에 발생하는 점액 낭종으로 타액선 분비도관의 파열로 인하여 점액이 연조직 내에 저류되어 생기는 가성낭종이다. 구강저의 설소대를 중심으로 편측으로 발생하며 무통성이고, 병소의 크기가 증가함에 따라 피막이 얇아져서 청색의 투명한 종창이 되는 것이 특징이다. 병소의 크기가 큰 경우에는 연하 및 발음, 저작시 문제를 야기할 수 있지만 외부로 종창이 생기거나 감염되는 것은 드물다. 하마종의 치료법으로는 자발적으로 치유되는 것을 관찰하는 방법, 단순 절개 배농, 조대술, 절제술 등이 있다. 치료법 중 하나인 조대술은 낭벽의 일부분을 제거하여 구강 점막과 연결시켜주는 술식으로 보존적이며 소아에서 추천되는 방법으로 구강내 조직의 외형을 원형대로 유지할 수 있고, 해부학적 구조물을 손상시킬 위험성이 적은 장점을 가진다. 치료 후에 자주 재발될 수 있으며, 술 후 4개월 이내에 일어난다. 이 증례는 하마종을 주소로 내원한 8세 여아에서 조대술을 시행하고 관찰하였으며 재발소견 없이 정상적인 소견을 보인바 보고하는 바이다.

Keywords

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