Management of Oral Ranula

Abstract

Objective: Preferred treatment of oral ranulas remains controversial. We present our experience with ranulas at Gumi CHA Medical Center (GCMC) and review the literature. Method: Retrospective review. From 2002 to 2010, 61 oral ranulas were treated at GCMC. Combining the GCMC series with the literature identified 271 cases for review. Results: In the GCMC series, procedures for oral ranulas varied from ranula excision (9 cases, 32%), marsupialization (18 cases), combined ranula and sublingual gland excision (24 cases, 45%), sclerotherapy with OK-432 (10 cases, 23%). Recurrences of ranula excision only, marsupialization, combined ranula and sublingual gland excision, and sclerotherapy were 5 cases (56%), 5 cases (28 %), 0 cases (0%), and 5 cases (50%), respectively. Sixty complications were identified from the literature. Recurrence was considered a complication and was most prevalent (68%). Nonrecurrent complications included tongue hypesthesia (12%), bleeding/hematoma (12%), postoperative infection (7%), and Wharton’s duct injury (2%). Procedures and associated complication rates were: ranula excision only (20%), marsupialization (20%), combined ranula and sublingual gland excision (13%), and sclerotherapy (57%). Conclusion: Based on our review, definitive treatment yielding lowest recurrence and complication rates for oral ranulas is transoral excision of the ipsilateral sublingual gland and ranula.