• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.5
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• pp.543-547
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• 2007

The plunging ranula is a kind of ranula that goes over the mouth floor to the neck and other adjacent tissue. Sublingual gland is gently accepted as origin of plunging ranula. Plunging ranula develops commonly because of rupture of sublingual gland duct by trauma and extravasation of salivary secretion to the adjacent tissue. It is not true cyst so that there is no epithelium. And it consisted with thin connective tissue, inflammation cell infiltration and salivary secretion. Left without treatment, it can grow into the 10 cm more huge lesion. This report is a case of 73 years old female who was diagnosed as plunging ranula with review of literature. She presented 5 cm submandibular swelling at first. When surgery was delayed because of patient's condition, the lesion grew into the l2cm huge size. We performed excision of sublingual gland, submandibular gland and plunging ranula and had a good result without recurrence.

• Korean Journal of Head & Neck Oncology
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• v.12 no.1
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• pp.65-68
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• 1996

The incidence of plunging ranula has been reported as about 10% of all ranula cases. Treatment consists of wide surgical excision or marsupialization. However, it seldom provides a satisfactory result and various modalities of treatment have been proposed in addition to surgical extirpation. We reported our experience using intralesional OK-432 sclerotherapy for a case of plunging ranula in 20 year-old male patient. The OK-432 solution was prepared by dissolving 0.1 KE in 2ml of physiologic saline and was instilled in the same amount of the aspirated cystic fluid. Following two instillations, the lesion completely disappeared. The side effects were mild fever for 3 days and a mild local induration for several days. At present, 9 months after instillation, no recurrence was observed. OK-432 sclerotherapy appears to be simple, safe and effective method for the treatment of plunging ranula.

• Korean Journal of Head & Neck Oncology
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• v.18 no.1
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• pp.84-86
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• 2002

Plunging ranula is occured in about 10% of all ranula cases although surgery is the first choice therapy. However, frequent recurrences of the disease due to insufficient surgery have been reported, and various therapies have been designed in addition to surgery. We here report a case on whom we conducted intralesional injection of OK-432 for recurrent plunging ranula. A 36-year-old man was admitted who had a 2-months history of swelling of right submandibular area. He had been operated for right plunging ranula twice, 7 years ago. Under fluoroscopic guidance, contents of the ranula were aspirated and OK-432 solution was injected twice with 3-week interval. Examination after 6 weeks showed that the cystic ranula seen before therapy had disappeared completely and no recurrence was encountered after 18months. Therefore the intralesional injection of OK-432 is effective method for treatment of the plunging ranula.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.6
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• pp.589-592
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• 2008

Running title: A plunging ranula extended into parapharyngeal space Ranulas are lesion of sublingual gland origin, which occur in the floor of the mouth. Most ranulas, whether simple or plunging, are pseudocysts without and epithelial lining and ranulas have higher levels of salivary amylase and protein content. They can be classified into two types based on their extent: simple ranulas, confined to the sublingual space and plunging ranula which extend into adjacent spaces. Plunging ranula requires differential diagnosis with other lesions (neuroma, monomorphic adenoma, hemangioma, lipoma, dermoid cyst, lateral cervical cyst). The patient was diagnosed as plunging ranula. We experienced 17 years old male, visited to our department, who complain Rt. cervical swelling and in MRI view, this lesion involved sublingual, submadibular, parapharyngeal, skull base. We experienced a rare case of plunging ranula, extended into parapharyngeal space. We report the case.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.4
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• pp.361-365
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• 2001

Whereas oral ranula is relatively common and presents as a cyst in the mouth, the plunging ranula is rare and manifests itself as a mass in the neck with or without an associated oral lesion. When there is a soft anterior neck swelling without oral swelling, diagnosis is still difficult. In such a case, clinical suspicion may be low and the pathologist may be misled by the histologic appearance. Recognition of the diagnosis of plunging ranula is essential for the correct treatment of these lesions. We report a case of a 4-year-old girl and review the literatures to discuss the differential diagnosis and treatment modalities.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.45 no.6
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• pp.357-363
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• 2019

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. This phenomenon is called plunging ranula. A variety of treatments for ranula has been suggested and include aspiration of cystic fluid, sclerotherapy, marsupialization, incision and drainage, ranula excision only, and excision of the sublingual gland with or without ranula. Those various treatments have shown diverse results. Most surgeons agree that removal of the sublingual gland is necessary in oral and plunging ranula. Four patients with ranula were investigated retrospectively, and treatment methods based on literature review were attempted.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.3
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• pp.241-245
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• 1998

The plunging ranula or cervical ranula is amucous extravasation cyst of the sublingual gland. It is slightly common in females, shows no side preference, and is more prevalent in the second and third decades of life. It typically manifests as a painless, nonmobile swelling in the neck. The pathogenesis of plunging ranula is the discontinuities of the mylohyoid muscle in a position that would allow extravasation of sublingual gland mucin. The histologic appearance is characteristically of a cyst, devoid of epithelium or endothelium, with a vascular fibro-connective tissue wall containing some chronic inflammatory cells and macrophages stuffed with mucin. The correct diagnosis is essential for the most effective treatment, which is exicision of the sublingual gland. The plunging ranula must be differentiated clinically and histomorphologically from thyroglossal duct cyst, dermoid cyst, branchogenic cyst, lymphangioma, laryngocele, lipoma, hemangioma, cervial thymic cyst, cysts of the parathyroid or thyroid gland, lymphadenopathy, abscess, or tumor. We report a case and review the literatures, in our case, 23-year old man were diagnosis as plunging ranula after have been taken sialogam, MRI, etc. He underwent surgery via a cervical approach. The ranula reached the anterior neck by passing through a dehiscence in the mylohyoid muscle. A pseudocyst was extirpated. Although total sublingual gland excision was not performed, no recurrence was observed during 6 months follow-up periods.

• Korean Journal of Head & Neck Oncology
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• v.39 no.1
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• pp.49-52
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• 2023

Sublingual resection is known as the most effective treatment of choice to prevent recurrence in patients with plunging ranula. In this case report, we present our experience with a 37 year-old man with prolonged upper neck mass diagnosed as plunging ranula. He had persisting mass lesion even after 4 times of sclerotherapy. Due to fibrotic change the pseudocyst could not be drained after removing the sublingual gland. To resolve the mass lesion, ultrasonography guided transoral drainage was performed. Intraoperative ultrasonography may be useful for transoral drainage of plunging ranula difficult to approach after sublingual resection.

• Archives of Craniofacial Surgery
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• v.11 no.2
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• pp.111-115
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• 2010

Purpose: A plunging ranula is relatively uncommon and represents a mucus escape reaction occurring from a disruption of the sublingual salivary gland. It is a common condition found in young adults, even though the reported age range is 2 - 61 years. We report our experience of a complete excision of a plunging ranula via the intraoral and submandibular approach. Methods: A 23-year-old man had a large protruding mass in the right submandibular area. Initially, the protruding mass appeared bilaterally but the left side disappeared spontaneously. The MRI findings revealed a homogenous fluid attenuation mass in the submandibular space, suggesting a ranula. The sublingual gland was extirpated through the intraoral approach and the ranula excised totally via the submandibular approach. Results: The patient had an uneventful postoperative course without infection, paralysis and tongue sensory changes, etc. The pathology findings were characteristic of a pseudocyst without a lining epithelium or endothelium but with a vascular fibro-conective tissue wall filled with mucinous fluid. No recurrence was observed on the submandibular area during the 8 month follow-up period. Conclusion: The combined intraoral approach and submandibular approach is an effective and highly recommended method for sublingual gland extirpation and complete excision of a plunging ranula.

• Archives of Plastic Surgery
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• v.37 no.1
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• pp.75-78
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• 2010

Purpose: Whereas oral ranula is relatively common and presents as a cyst in the mouth, the plunging ranula is rare and manifests itself as a mass in the neck with or without an associated oral lesion. The purpose of this study is to examine the clinical characteristics of rare bilateral plunging ranula arising from accessory submandibular gland in order to provide our experience for its correct diagnosis and treatment. Methods: A 13-year-old girl manifests as a slow growing painless, non-mobile swelling in the anterior neck. She underwent surgery via a cervical approach. A pseudocyst was extirpated and adjacent accessory gland tissue and related lymph node were removed. Results: The histologic appearance is characteristically of a cyst, devoiding of epithelium or endothelium, with a vascular fibro-connective tissue wall containing some chronic inflammatory cells and macrophage stuffed with mucin. Pathologic findings represented a form of myxomatous degeneration and lined by condensed connective tissue and granulation tissue. The nature of the accessory gland tissue was same as subligual gland. Although total submandibular or sublingual gland excision was not performed, no recurrence was observed during 6 months follow-up periods. Conclusion: Usually, unilateral plunging ranula develops commonly because of rupture of sublingual gland duct by trauma and extravasation of salivary secretion to the adjacent tissue. But our case developed because of bilateral congenital accessory submandibular gland. This is thought to be a result from a congenital failure of canalization of the terminal end of the duct. Finally, the correct diagnosis is essential for the most effective treatment, which is excision of the ranula and related accessory salivary gland. We performed excision of accessory submandibular gland and plunging ranula and had a good result without recurrence.