Modified Marsupialization of Simple Ranula in a Child and Review of Management Techniques

Abstract

A ranula is a bluish dome shaped swelling in the floor of the mouth resulting from accumulation of saliva from the sublingual gland. It is of two types simple and plunging ranula. The management is difficult due to its anatomic location. Children pose a greater challenge while managing this condition due to their age and behavioural problems. An 8-year-old girl reported with a sublingual ranula on the floor of the mouth. The swelling was marsupialized under local anesthesia followed by betadine-soaked gauze packing changed at three-day intervals. Complete resolution of the lesion took place with no signs of recurrence after a follow up of 1 year. Various treatment options are available for management of pediatric ranulas. Micro-marsupialization and marsupialization are relatively less invasive procedure and its use in management of pediatric ranulas demonstrates lesion resolution with low recurrence when combined with packing of the pseudocyst. Invasive methods like complete excision with or without removal of the sublingual gland can lead to local complications. Other option for management includes lasers, sclerotherapy with OK-432,botulinum toxin type and nickel gluconate – mercurius heel – potentised swine organ preparations.