Transoral Complete vs Partial Excision of the Sublingual Gland for Plunging Ranula

Otolaryngol Head Neck Surg. 2022 Sep;167(3):479-483. doi: 10.1177/01945998211067500. Epub 2021 Dec 21.

Abstract

Objectives: Plunging ranula is a pseudocyst of saliva extravasated from the sublingual gland (SLG) to the submandibular space. This is treated by transoral excision of the SLG or transcervical cyst excision that might differently affect surgical morbidity and recurrence. This study compared the clinical outcomes of complete vs partial excision of the SLG for plunging ranula.

Study design: A nonrandomized comparative study.

Setting: Academic medical center.

Methods: This study included 42 patients with plunging ranula who underwent complete or partial excision of the SLG with the evacuation of cystic content. Two surgical methods of complete or partial SLG resection were alternatively allocated to consecutive patients without randomization. The primary outcome was a postoperative recurrence. Secondary outcomes were operation time and complications.

Results: Complete and partial excision of the SLG was performed in 22 and 20 patients, respectively, without injury to the Wharton's duct or the lingual nerve. Postoperative complications in 42 patients were minor with temporary events: hematoma, 1 (5%); tongue numbness, 2 (5%); dysgeusia, 4 (9%); and dysphagia, 2 (5%), which did not differ between patients with complete and partial excision of the SLG (P > .1). However, recurrence occurred in only 5 of 20 patients with partial SLG excision but none of 22 patients with complete SLG excision for a median follow-up of 36 months.

Conclusions: Complete SLG excision is preferred over partial SLG excision to treat plunging ranula for reducing postsurgical risks of complications and recurrence.

Keywords: complications; plunging ranula; recurrence; sublingual gland; transoral excision.

MeSH terms

  • Humans
  • Mouth Floor / surgery
  • Oral Surgical Procedures* / methods
  • Ranula* / etiology
  • Ranula* / surgery
  • Salivary Ducts
  • Sublingual Gland / surgery