Complex (Diving, Plunging) Ranula

Epidemiology

Ranulas are cystic lesions arising in the sublingual space (floor of mouth) that are believed to result from obstruction of the sublingual or minor salivary gland. The obstruction is most commonly thought to be congenital or posttraumatic in origin. The cysts develop from continued secretion of the mucous glands into an obstructed duct. Ranulas have also been referred to as mucoceles or pseudocysts in the floor of mouth. Although ranulas have been reported in all age groups, they are most common in children and young adults. There is no reported gender predilection.

Clinical Findings

There are two types of ranulas. A simple ranula is the most common form. By definition, simple ranulas are above the mylohyoid muscle and are confined to the sublingual space. They are usually paramedian and are situated in the vicinity of the sublingual gland. Simple ranulas present as mucosal covered masses within the floor of mouth. These masses are typically cystic in nature and exhibit a characteristic translucent, bluish hue (“frog belly” appearance). Ranulas may occasionally rupture, causing expulsion of viscid fluid into the oral cavity.