Diagnosis and treatment of 64 cases of ranula

Abstract

Ranulas are caused by the rupture or obstruction of the sublingual gland ducts, resulting in exudative or retention-type cysts. The author collected cases admitted over the past four years for a retrospective study, analyzing the diagnostic methods and therapeutic outcomes. Patients diagnosed with ranula who underwent inpatient surgery at the Department of Oral and Maxillofacial Surgery of Nantong First People’s Hospital from January 2022 to December 2025 were collected. Statistical analysis was conducted on their gender, age, diagnosis, and treatment outcomes. A total of 64 patients met the criteria, including 22 males and 42 females. There were 57 cases of the intraoral type and 7 cases of the extraoral type. All intraoral cases were diagnosed preoperatively through clinical examination, while the extraoral cases were diagnosed by CT (1 case), MR (5 cases), and ultrasound (1 case). Sixty-two patients underwent intraoral approach sublingual gland and cyst excision, with an average operation time of (51.84 ± 20.27) minutes. One extraoral case underwent excision of the sublingual gland, submandibular gland, and cyst through a submandibular incision, and one case underwent marsupialization. The postoperative follow-up period ranged from 6 months to 4 years. Postoperative complications included 5 cases of numbness at the tips of the tongues, 2 of which persisted for 1 year after surgery, and 3 cases recovered within 3 months. One patient had significant bleeding from the floor of the mouth 3 h after surgery and recovered normally after a second operation. There was no local infection, and one intraoral case recurred 3 months after surgery. The intraoral type of ranula is more common, and the diagnostic method is clear. The diagnosis and treatment of the extraoral type pose challenges to clinical practice. Although complete excision of the sublingual gland is currently the preferred treatment option, there is still a certain probability of complications.