A 17-year surgical experience of the intraoral approach for ranulas

Abstract

Introduction: The aim of this study was to analyze the clinical features and treatment outcomes in order to determine the optimal management of ranulas in our Oral and Maxillofacial Surgery department with long-term results.

Patients and methods: A retrospective study was performed to evaluate patients with a final diagnosis of a simple or plunging ranula at Lille Teaching Hospital from May 2000 to January 2017. Clinical data on ranulas that were reviewed included gender, age, symptoms, location of the lesion, surgical procedures, complications, recurrence and follow-up.

Results: The 26 patients included in the study comprised 18 males and 8 females, ranging from 3-months to 38 years of age. A total of 27 ranulas were managed: 25 oral ranula and 2 plunging ranulas. Twelve patients had undergone marsupialization (44.4%), 7 patients had complete excisions of the ranula (25.9%) or partial excisions combined with marsupialization (14.8%) and 4 patients (14.8%) had undergone excision of the sublingual gland (SLG). Seven ranulas recurred (25.9%). Not a single case recurred following the excision of the SLG. Treatments that included marsupialization were associated with the lowest recurrence rate (16.7%) after SLG excision, followed by combined marsupialization and ranula excision (25%) and by ranula excision alone (57%). There were no major complications.

Discussion: Long-term outcomes confirm the different surgical procedures available in the outpatient clinic for the management of ranulas based on our surgical experience. Transoral resection of the SLG should be the optimal treatment, producing the lowest recurrence rate.

Keywords: Long-term follow-up; Marsupialization; Ranula; Recurrence; Sublingual gland (SLG) excision; Surgical approach.