Plunging Ranula with the Oral Counterpart in A 6-Year-Old Boy: A Case Report

Abstract

A ranula is a collection of salivary fluid on the floor of the oral cavity due to obstruction of the salivary duct or as a result of extravasation of the saliva. A plunging ranula results from extension of salivary fluid into the submental or submandibular spaces through the posterior aspect of the mylohyoid muscle or through a dehiscence on the muscle. It could also extend to multiple spaces mimicking cystic lesions of the neck region. Ranula mostly involve the sublingual gland. The prevalence of ranula is 0.2% per 1000 patients. There are usually no symptoms except when large which then causes discomfort in mastication and swallowing. Various treatment options have been advocated but the most commonly adopted one is drainage of the collection in addition to excision of the affected gland. The case presented is an oral and plunging ranula found in a 6-year-old boy of eight weeks duration. Presenting symptoms were painless swelling underneath and beside the tongue in addition to swelling at the submental region. There was occasional discomfort during mastication and swallowing. Ultrasound scan showed a 40mm by 30 mm cystic mass. The ranula was excised through the intraoral route together with excision of the implicated left sublingual gland. Post-operative reviews show no recurrence.
 Conclusion: Oral and plunging ranula do occur in children. Transoral approach to the drainage of the salivary collection with the excision of the affected sublingual gland is appropriate in the management of this condition.