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Abstract
Several methods of treatment for plunging ranulas have been described in the literature, such as: surgical treatment including the excision of the sublingual gland followed by transoral drainage of the pluging ranula, needle aspiration, excision of the ranula, cryosurgery and CO(2) laser excision. Marsupialization and micro-marsupialisation can be also recommended primarily to treat oral ranulas. The aim of this paper is to present the treatment of pediatric ranula with liquid nitrogen cryosurgery performed in a 8 year, 6-month-old male, without local anesthesia. We have outlined the current protocol of cryosurgery recommended in the management of ranulas, both clinical advantages and disadvantages, with emphasis on the clinical outcomes and also pediatric patients' safety. At the 1year follow-up visit, the lesion had disappeared completely. There was no recurrent lesion. Liquid nitrogen cryosurgery for management of ranulas may become a primary treatment modality prior to surgery in children.
Highlights
Ranulas are large retention phenomena that occur in the floor of the mouth in relation to the sublingual gland and they can be classified into 2 groups: simple and plunging ranula
Primary treatment of plunging ranula has consisted of removal of the sublingual gland with excision or suction of the ranula[3,4]
This paper presents the cryosurgery as an alternative therapy to treat pediatric plunging ranula
Summary
Ranulas are large retention phenomena that occur in the floor of the mouth in relation to the sublingual gland and they can be classified into 2 groups: simple and plunging ranula. According to Jain et al.[2] plunging ranulas are pseudocysts that originate in the sublingual salivary gland and extend to the submandibular space and into deeper cervical spaces like the paraphayngeal space. Pediatric plunging ranula is rare, with only a few reports in the literature[3]. Several methods of treatment for plunging ranulas have been described in the literature. Primary treatment of plunging ranula has consisted of removal of the sublingual gland with excision or suction of the ranula[3,4]. This paper presents the cryosurgery as an alternative therapy to treat pediatric plunging ranula. We have outlined the current protocol recommended in the management of plunging ranulas, clinical advantages, with emphasis on the clinical outcomes and pediatric patients’ safety
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