Goodlettsville Dental Services

Ranula

A ranula is a type of mucocele found on the floor of the mouth. Ranulas present as a swelling of connective tissue consisting of collected mucin from a ruptured salivary gland duct, which is usually caused by local trauma.

The Latin rana means frog, and a ranula is so named because its appearance is sometimes compared to a frog’s underbelly.

Appearance

An oral ranula is a fluctuant swelling with a bluish translucent color that somewhat resembles the underbelly of a frog Rana. If it is deeper it does not have this bluish appearance. If it is large ( 2 or more cm.), it may hide the salivary gland and affect the location of the tongue. Most frequently it stems from the sublingual salivary gland, but also from the submandibular gland.

Though normally above the mylohyoid muscle, if a ranula is found deeper in the floor of the mouth, it can appear to have a normal color. A ranula below the mylohyoid muscle is referred to as a "plunging or cervical ranula", and produces swelling of the neck with or without swelling in the floor of the mouth.

Ranulas measure several centimeters in diameter and are usually larger than mucoceles. As a result, when ranulas are present the tongue may be elevated. As with mucoceles, ranulas may be subject to recurrent swelling with occasional rupturing of its contents. When pressed, they may not blanch.

Symptoms

Ranulas may be asymptomatic, although they can fluctuate rapidly in size, shrinking and swelling, making most ranulas hard to detect. However, if it gets large enough it may interfere with swallowing. The overlying mucosa is usually intact. The swelling is not fixed and is non-painful unless it becomes secondarily infected.

Histology

Microscopically, ranulas are cystic saliva filled distensions of salivary gland ducts on the floor of the mouth alongside the tongue, and lack a true epithelium.

Treatment

Treatment of ranulas could involve either marsupialization or more often excision of both the gland and lesion. Ranulas are likely to reoccur if the sublingual gland or other gland causing them is not also removed with the lesion. There is little morbidity or mortality connected with treatment.