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Patient Reports / LoginWhat Is a Ranula? Symptoms, Causes, Diagnosis & Treatment
Written by Medicover Team and Medically Reviewed by Dr Shashi Kiran Somala , ENT
Table of Contents
A ranula is a mucous cyst that develops in the floor of the mouth due to leakage of saliva from a damaged or blocked salivary gland duct. Although it is usually benign, a ranula can enlarge over time and interfere with speaking, swallowing, or eating if left untreated.
Ranula is a type of mucous cyst that occurs in the floor of the mouth. It is essential to understand the causes, symptoms, and treatment options to effectively manage this condition.
Ranula is a mucous extravasation cyst that forms in the floor of the mouth. The term "ranula" is derived from the Latin word "rana," meaning frog, as the swelling resembles a frog's underbelly.
Ranulas are typically caused by the rupture of a salivary gland duct, leading to the accumulation of saliva in the surrounding tissues.
What Are the Types of Ranula?
Ranulas are classified according to their location and extent. Identifying the type of ranula helps healthcare providers choose the most appropriate treatment and reduce the risk of recurrence.
Ranulas are classified into two main types:
- Simple Ranula: Confined to the floor of the mouth.
- Plunging Ranula: Extends into the neck through the mylohyoid muscle.
Understanding the type of ranula is crucial for determining the appropriate treatment approach.
What Causes a Ranula?
A ranula develops when saliva leaks into the surrounding tissues because of injury or blockage of a salivary gland duct. Several conditions can contribute to this process, including trauma, duct obstruction, and inflammation.
Salivary Gland Trauma
The most common cause of ranula is trauma to the salivary glands. This trauma can result from accidental biting, dental procedures, or even certain medical conditions that affect the salivary glands.
Obstruction of Salivary Ducts
Obstruction of the salivary ducts, often due to sialoliths (salivary stones) or strictures, can lead to the formation of a ranula. The obstruction prevents the normal flow of saliva, causing it to accumulate and form a cyst.
Inflammatory Conditions
Inflammatory conditions such as sialadenitis can also contribute to the development of ranula. Inflammation can lead to the rupture or obstruction of the salivary ducts, resulting in cyst formation.
What Are the Symptoms of a Ranula?
Recognizing the symptoms of a ranula is important for timely diagnosis and treatment. Symptoms usually depend on the size and location of the cyst and may gradually become more noticeable as it enlarges.
Recognizing the symptoms of ranula is essential for prompt diagnosis and treatment. The primary symptoms include:
- Swelling: A painless, bluish swelling in the floor of the mouth is the hallmark of ranula.
- Discomfort: Although typically painless, larger ranulas can cause discomfort, difficulty speaking, and swallowing.
- Recurrent Swelling: The swelling may fluctuate in size, often increasing after meals.
Differentiating Ranula from Mucocele
It is important to differentiate ranula from mucocele, another type of mucous cyst. While both conditions involve the accumulation of saliva, mucoceles are typically smaller and occur in the inner lining of the lips, cheeks, or the floor of the mouth.
When Should You See a Doctor for a Ranula?
Seek medical evaluation by an ENT Specialist or Oral and Maxillofacial Surgeon if you notice a persistent swelling under the tongue or in the floor of the mouth, especially if it interferes with eating, speaking, or swallowing. Early diagnosis can help prevent complications and determine the most appropriate treatment.
You should see a doctor if you have:
- A painless or recurrent swelling under the tongue.
- Difficulty speaking, chewing, or swallowing due to mouth swelling.
- A swelling that continues to enlarge or repeatedly returns.
Get medical help immediately if:
- You develop difficulty breathing or severe swallowing problems.
- The swelling becomes painful, red, or is associated with fever.
- You experience rapid enlargement of the swelling or significant neck swelling.
These could be signs of a serious complication of a Ranula that requires prompt medical care.
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How is a Ranula Diagnosed?
Diagnosing a ranula involves a physical examination and, when necessary, imaging studies to determine the size and extent of the cyst. Additional procedures may help distinguish a ranula from other cystic lesions of the mouth.
Clinical Examination
A thorough clinical examination by a healthcare professional is the first step in diagnosing ranula. The characteristic bluish swelling in the floor of the mouth is usually indicative of the condition.
Imaging Studies
Imaging studies such as ultrasound, MRI, or CT scans can provide detailed information about the size, extent, and location of the ranula. These studies are particularly useful in diagnosing plunging ranulas, which extend into the neck.
Fine Needle Aspiration (FNA)
Fine needle aspiration (FNA) can be used to confirm the diagnosis by extracting fluid from the cyst for analysis. This procedure helps in differentiating ranula from other cystic lesions in the oral cavity.
What is the Treatment for a Ranula?
Treatment for a ranula aims to remove the cyst, restore normal salivary drainage, and reduce the chance of recurrence. The treatment method depends on the size, location, and type of ranula.
Treatment options for ranula vary based on the type, size, and symptoms of the cyst. The primary goal of treatment is to remove the cyst and prevent recurrence.
Marsupialization of Ranula
Marsupialization is a common surgical procedure used to treat ranula. The procedure involves creating a small incision in the cyst and suturing the edges to form a permanent opening, allowing continuous drainage of saliva.
Excision of Ranula
Complete excision of the ranula and the affected salivary gland is another treatment option. This procedure is often recommended for larger or recurrent ranulas to prevent recurrence.
Sclerotherapy
Sclerotherapy involves injecting a sclerosing agent into the cyst to induce fibrosis and shrink the cyst. This minimally invasive procedure is often used for smaller ranulas.
Laser Treatment
Laser treatment is an emerging option for the treatment of ranula. The laser is used to create an opening in the cyst, promoting drainage and reducing the size of the cyst.
Plunging Ranula Management
The management of plunging ranula is more complex due to its extension into the neck. Treatment may involve a combination of surgical excision and marsupialization to ensure complete removal and prevent recurrence.
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How Should You Care for a Ranula After Treatment?
Proper follow-up and oral care after treatment help promote healing, reduce discomfort, and lower the risk of recurrence or infection.
Monitoring for Recurrence
Regular follow-up appointments are essential to monitor for recurrence of ranula. Patients should report any new swelling or symptoms to their healthcare provider promptly.
Oral Hygiene
Maintaining good oral hygiene is crucial to prevent infections and complications after treatment. Patients should follow their healthcare provider's instructions regarding oral care and any prescribed medications.
Managing Post-Surgical Discomfort
Post-surgical discomfort can be managed with over-the-counter pain relievers and warm saline rinses. Patients should avoid spicy and acidic foods that may irritate the surgical site.
What Are the Complications of Ranula Treatment?
Most people recover well after treatment, but some temporary side effects or recurrence may occur. Understanding these potential complications helps ensure appropriate follow-up and timely management.
The most common side effect is mild, painless swelling in the treated area, which may last for several days after the procedure. Patients can resume normal eating immediately, and since there are no incisions or stitches, no wound care or dressings are needed.
In some cases, the ranula may not be completely resolved with a single treatment, and a second session may be required. On rare occasions, the affected gland may resist the medication injections, causing continued saliva leakage, which may require referral to an experienced surgeon for traditional surgical removal.
Frequently Asked Questions
1. How does a ranula differ from a mucocele?
A mucocele is a smaller cyst typically found in the lips or cheeks due to blocked minor salivary glands, whereas a ranula occurs specifically under the tongue, often as a result of blocked major salivary glands. The size and location of the cyst distinguish the two.
2. Can a ranula go away on its own?
While small ranulas may resolve over time, most do not go away on their own. Without treatment, they may persist, enlarge, or cause discomfort. Surgical intervention is often necessary for proper resolution, particularly for larger or recurrent ranulas.
3. Is a ranula dangerous?
A ranula is typically not dangerous and is considered benign. However, if left untreated, it can cause complications such as difficulty swallowing, speech problems, or infection. In rare cases, it may lead to more serious issues like airway obstruction or recurrent infections.
4. Can a ranula recur after treatment?
Yes, a ranula can recur after treatment, especially if the underlying cause, like a blocked salivary duct, isn't fully addressed. Surgical removal of the affected gland or marsupialization tends to reduce the chances of recurrence, though there is still a small risk.
5. How long does it take to recover from ranula surgery?
Recovery from ranula surgery generally takes about 1-2 weeks, during which time swelling and discomfort may subside. Full recovery can take several weeks, depending on the surgical approach. Following proper post-operative care instructions can help reduce recovery time.
6. Is a ranula painful?
A ranula is usually painless, but it can cause discomfort or pressure if it grows large enough to interfere with swallowing or speaking. In some cases, if the cyst becomes infected, it may cause pain, redness, or swelling around the affected area.
