A ranula is a type of cyst that forms in the floor of the mouth due to blocked or damaged salivary glands. It is a fluid collection or cyst that forms in the mouth under the tongue. It is filled with saliva (spit) that has leaked out of a damaged salivary gland.
Salivary glands are small structures around the mouth which make saliva. Saliva should drain from these glands directly into the mouth. If one of these glands is damaged then the saliva leaks out into the tissues next to the gland forming a cyst or bubble near the gland. This cyst is called a ranula.
These slow-growing benign growths are found on the floor of the mouth and can vary in size.
Types of Ranula –
• Simple Ranula:
A cyst located within the sublingual gland duct and swelling is also confined to the sublingual gland. This is the smallest of the three paired salivary glands around the throat and mouth.
• Plunging Ranula:
It occurs when a simple ranula ruptures. The rupture triggers the formation of a pseudocyst that extends into the neck through a defect of the mylohyoid muscle, which is a group of neck muscles that control the tongue. This causes a mass in the submandibular space.
Ranulas are usually discovered by the patient, the patient’s family, or the patient’s medical caregivers like medical doctors and dentists. It usually is a 2-3 inch diameter painless soft swelling under the tongue or chin that is easy to identify. Occasionally, the fluid collection can hurt a little and sometimes is can spontaneously empty into the mouth only to slowly fill back up in the weeks after it empties. Usually, it just slowly grows in size until it is discovered.
• Visible Swelling: Usually painless, translucent but noticeable lump under the tongue.
• Discomfort: May cause mild discomfort or difficulty in swallowing.
Saliva is fluid formed primarily by three salivary glands on either side of the mouth: the parotid glands, the submandibular glands, and the sublingual glands. If one of the salivary glands, usually the sublingual gland, is injured or diseased the saliva will no longer reach the mouth where it can be swallowed. The saliva leaks out of the injured gland and forms a bubble of fluid in the tissue around the gland which is called a ranula.
Sometimes, the cause of a ranula is unknown and the swelling occurs spontaneously.
• Blocked Ducts: Accumulation of saliva due to blockage or rupture of salivary ducts.
• Trauma: Injury to the salivary glands can lead to ranula formation.
Risk Factors –
Some of risk factors that makes you more prone to develop ranula under your tongue includes –
• Age: More common in young adults.
• Gender: Slightly more prevalent in males.
• Previous Ranula: Having a history increases the likelihood.
• Infection: Prolonged existence may lead to secondary bacterial infection.
• Breathing Difficulty: Plunging ranulas may cause airway obstruction.
• Clinical Examination: Physical inspection and palpation of the swelling.
• Imaging Studies: Ultrasound or MRI for a detailed view.
• Fine Needle Aspiration (FNA): Extracting fluid for analysis.
• Observation: Small, asymptomatic ranulas may be monitored.
• Needle Aspiration: Draining the cyst with a needle.
• Marsupialization: Creating an opening to allow continuous drainage.
• Surgical Removal: Excision of the ranula and, if necessary, the associated gland.
Ayurvedic Perspective –
In Ayurveda Ranula could be correlated with Upjihwika describedunder mukhgata rogas. This condition occurs in relation to tongue. Ayurvedic Treatment could help to resolve this problem. Some of beneficial Ayurvedic medicine includes –
• Kanchnar Guggulu
• Vriddhivadhika Vati
• Aarogyavardhini Vati
• Vyoshadi Vati
• Vyoshadi Churna
• Nirgundi Patra
Post-Treatment Care –
Pain Management: Prescribed pain relievers if needed.
Follow-up: Regular check-ups to monitor healing and prevent recurrence.
Prevention Strategies –
• Oral Hygiene: Maintaining good oral health reduces the risk of salivary gland issues.
• Avoiding Trauma: Being cautious to prevent injuries to the mouth area.
• Favorable: Most cases have a good prognosis with proper treatment.
• Recurrence: Regular follow-ups are essential to monitor and prevent recurrence.
In summary, ranulas are benign but can cause discomfort and complications if left untreated. Timely diagnosis, appropriate treatment, and postoperative care play crucial roles in ensuring a positive outcome for individuals affected by this condition. Regular dental check-ups and maintaining oral hygiene are essential for preventing the development of ranulas and other oral health issues.
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