A Giant Diving Ranula Extending to the Skull Base in Pediatric Age

Kumbul Y.C. Okur N. Çiriş I.M. Okur E. Sivrice M.E. Akin V.
1 July 2021 Lippincott Williams and Wilkins

Journal of Craniofacial Surgery
2021 #32 Issue 5 E515 - E517 pp.

Ranula is a retention cyst that develops from the salivary glands. It has 2 subtypes, oral and diving. There are differences in the clinical features of ranula subtypes. In particular, diving ranula is more prone to extend in the neck spaces than oral ranula. The enlargement of the diving ranula is generally downward in the neck. If the opposite occurs, we may encounter very interesting and difficult cases. Diving ranula should be kept in mind in the differential diagnosis of cystic neck masses in the pediatric age group and its treatment should be done surgically.A 15-year-old girl admitted to our clinic with the complaint of swelling in the floor of the mouth and neck. In physical examination of the patient, a mass with cystic content was observed adjacent to the left Wharton canal. In addition, a 4×3cm, soft, fluctuant, nonfixed, painless mass was palpated in the left submandibular area. Magnetic resonance imaging revealed that the neck mass was a diving ranula extending from the parapharyngeal space to the skull base. In the surgery, submandibular and sublingual salivary glands were removed together with the diving ranula. We observed no complications in the postoperative period.Magnetic resonance imaging should be used to confirm the diagnosis of diving ranula. In the treatment of diving ranula, excision of the ranula alone is not enough surgically. We also recommend excision of the submandibular and/or sublingual salivary glands associated with ranula to reduce the recurrence rate.

Child , otolaryngology , ranula , salivary glands , skull base

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Department of Oto-Rhino-Laryngology and Head and Neck Surgery, Faculty of Medicine, Suleyman Demirel University, Isparta, 32200, Turkey
Department of Radiology, Faculty of Medicine, Suleyman Demirel University, Kazakhstan
Department of Pathology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey

Department of Oto-Rhino-Laryngology and Head and Neck Surgery
Department of Radiology
Department of Pathology

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