A foreign body in the floor of the mouth

A case of unusual presentation of foreign body in the floor of mouth is reported. The patient presented with a history and clinical findings of sublingual ranula. Marsupialisation and sublingual sialadenectomy was planned. After marsupialisation, a foreign body (spray cover) was found between the lumen of the submandibular duct and the ranula.     

Die Tauchranula Ein seltenes Krankheitsbild

Zusammenfassung In dieser Fallbeschreibung wird über eine 24j?hrige Patientin mit einer seit 3 Monaten bestehenden, ausgedehnten rechtsseitigen Halsschwellung berichtet. Nach der operativen Entfernung der rechten Glandula sublingualis, der Glandula submandibularis und des rechts zervikalen, polyzystisch konfigurierten, fest mit dem umliegenden Bindegewebe verwachsenen Tumors wurde histologisch eine Retentionszyste, die mit einer Tauchranula vereinbar war, nachgewiesen. Die ?tiologie, Pathogenese, Klinik und Diagnostik der Tauchranula wurden beschrieben. Die verschiedenen Therapiem?glichkeiten werden im Hinblick auf deren Wertigkeit kontrovers diskutiert. Zur Sicherung der Diagnose Tauchranula und zur Dignit?tsabkl?rung wird eine operative Entfernung mit histologischer Aufarbeitung des entnommenen Gewebes empfohlen. Da es sich bei der Tauchranula histologisch um eine Retentionszyste oder Pseudozyste handelt, die von der Glandula sublingualis ausgeht, wird die gleichzeitige Entfernung der Drüse angeraten, um Rezidiven vorzubeugen. Bei ausgedehnten Befunden einer Tauchranula, wie in dem vorliegenden Fall, kann eine zus?tzliche Entfernung der Glandula submandibularis erforderlich werden.      

Treatment of a plunging ranula with fenestration and continuous pressure

We present a new method of fenestration and continuous pressure as a simple, effective and uninvasive procedure for the treatment of plunging ranulas. We have recently used in four female patients, aged 10-29 years old. After treatment, the patients remained symptom-free and assessment by magnetic resonance imaging (MRI) showed regression of the ranula in all cases. The procedure resulted in satisfactory healing and we advocate it as a simple and effective treatment that is better for patients than conventional treatment.     

5种检查方法在颈部舌下腺囊肿诊断中的评价

目的 :评价 5种检查方法在诊断颈部舌下腺囊肿中的作用。方法 :检查方法包括手法检查、B超、穿刺、淀粉酶检查、囊腔造影 +CT。以术中确定囊腔与舌下腺相连为最终诊断。记录每种检查方法误诊、误导发生率 ,客观评价各种检查的优缺点。结果 :突入颈部的舌下腺囊肿确诊率为 5 8.3% ,误诊率为 4 1.7%。在各项检查中 ,囊腔造影 +CT误诊率为 0 ,手法检查误诊率为 2 5 % ,B超占 2 0 % ,检查手段不全占 18.8% ,淀粉酶假阳性占 16 .7%。经 χ2 检验各检查的误诊率有显著性差异 (χ2 =19.36 ,γ =8,P <0 .0 5 )。不同检查结果的汇集会影响误诊率。结论 :在各单项检查中 ,囊腔造影 +CT误诊率最低 ,其它各项均有 2 5 % 16 .7%的误诊率 ,优选诊断步骤是手法检查→穿刺→造影 +CT。     

Giant dermoid cyst of the neck can mimic a cystic hygroma: using MRI to differentiate cystic neck lesions

OBJECTIVE: To describe differential features of giant cervical dermoid cysts and other cystic lesions of the head and neck. METHODS: Case report including magnetic resonance imaging, surgical excision, pathologic examination and correlation. RESULTS: We report the case of a 15-year-old boy who presented for evaluation of a slowly enlarging doughy submental mass. Ultrasound showed some features consistent with a cystic hygroma and both sclerotherapy and surgical excision were discussed with the family. However, an unusual solid component on magnetic resonance imaging (MRI) mitigated toward surgical excision. At surgery, the cystic mass was excised and measured 9.5 cm x 5.5 cm x 4.0cm. Histology showed a giant dermoid cyst similar to those seen in the ovary. The solid component was a smooth spherical collection of inspissated sebum. CONCLUSIONS: The unique MRI characteristics of giant dermoid cysts can help to separate these rare lesions from more common cystic hygromas. Fine needle aspiration should be considered for questionable lesions before treatment with OK 432 or similar agents.     

Intracystic injection of pingyangmycin(PYM)might be a more favorable option for treatment of oral and plunging ranulas

Ranulas are mucoceles that develop as a result of mucous extravasation from the sublingual gland and typically present in the floor of mouth.The treatment of ranulas are various,mainly including surgical and nonsurgical methods.The preferred treatment of oral and plunging ranulas is still uncertain.According to the complications associated with surgical therapy,nonsurgical sclerotherapy has been advocated by clinicians for its advantages of less injury,no scar,less suffering,etc.Recently,it was reported that OK-432 was a relatively effective sclerosing agent for both lymphatic malformations and ranulag,although it has a high rate of recurrence after treating ranulas.Pingyangmycin is another reported conventional sclerosing agent for lymphatic malformations.Herein,we hypothesize that intracystic injection of pingyangmycin may be an optimal method for the treatment of ranulas.     

浅谈微波治疗200例舌下囊肿、粘液囊肿患者的体会

舌下囊肿、粘液囊肿的治疗方法较多,如切除术、碘液注射法、冷冻法、激光治疗、电灼法等,效果都不很理想。自2003年5月至2008年5月,我科以微波治疗舌下囊肿、粘液囊肿200例,疗效满意,为抛砖引玉,现回顾性报道如下。     

Management of infant ranula

OBJECTIVE: Many surgical techniques to manage ranulas have been described in the literature. Ranula of infant patients was rare. Few studies have described the approach toward management in infant patients. METHODS: Eleven infant patients were treated for intraoral ranulas. The methods of treatment included aspiration of mucus, marsupialization and excision of the ranula and the ipsilateral sublingual gland. All cases were performed aspiration of mucus and observed for 6 months; and the marsupialization were recommended if the ranula recurred; the surgical resection of ipsilateral sublingual gland were performed if the ranula recurred when infant patients was about 1-year-old. These patients were followed up at least 24 months. RESULTS: Age of presentation ranged from 2 days to 3 months. There were six females (54.55%) and five males (45.45%). All cases presented simple (introral) ranula. Excision ranula with sublingual gland was performed on seven patients (63.64%) while marsupialization was performed on two patients (18.18%) and two patients (18.18%) were aspiration of the mucus of ranula and no recurrence. There were no recurrent lesions in all cases. CONCLUSION: Conservative treatment of infant ranula maybe includes observation for 6 months for spontaneous resolution. The methods for observation is performed the aspiration of mucus and marsupialization. The resection of ipsilateral sublingual gland is recommended if ranula recurred for infant patients about 1-year-old. We believe that it is safe that the submandibular duct and complete sublingual nerve are dissected before the sublingual gland is removed.