Clinical articles
Complications associated with surgical management of ranulas

https://doi.org/10.1016/j.joms.2004.02.018Get rights and content

Purpose

We present the intraoperative and postoperative complications associated with 606 procedures for ranulas in a series of 571 patients.

Patients and methods

Clinical records of 606 procedures in 571 patients with ranulas operated on in the Hospital of Stomatology, Wuhan University, China between 1962 and 2002 were retrospectively reviewed. The methods of surgery and intraoperative and postoperative complications were documented and analyzed.

Results

The most common complications were recurrence of the lesion (5.78%) and sensory deficit of the tongue (4.89%), followed by damage of Wharton’s duct (1.82%). Postoperative hematoma, infection, or dehiscence of the wound were seldom seen. Temporary numbness of the tongue resolved within 2 to 7 months postoperatively. Recurrences were often seen after marsupialization and excision of the ranula, with few recurrences after excision of the ranula and sublingual gland or excision of the sublingual gland alone.

Conclusion

Complications associated with ranula surgery are minor and self-limiting. Transoral excision of the sublingual gland has the least possibility of ranula recurrence.

Section snippets

Materials and methods

Five hundred seventy-one patients with ranulas had 606 procedures. All patients were treated surgically in the Department of Oral and Maxillofacial Surgery at the Hospital of Stomatology, Wuhan University, China.

Treatments used were excision of the lesion only, marsupialization, excision of the sublingual gland, or sublingual gland removal combined with ranula excision. Surgery was performed under local or general anesthesia. Tissues obtained at surgery were routinely sectioned and stained for

Results

Five hundred seventy-one patients had 606 operations, in which there were 9 marsupializations, 28 excisions of the ranula, 356 excisions of the sublingual gland, and 213 excisions of both the sublingual gland and ranula. Evaluation of damage of Wharton’s duct, postoperative bleeding or hematoma, dehiscence of wound, and infection were based on records of 606 procedures for treatment of ranulas. Loss of tongue sensation and recurrence of the lesion were evaluated by clinical examination or

Discussion

Ranulas are treated by various surgical methods. Marsupialization has a high recurrence rate, but is still used perhaps because of fear of potential surgical injury to adjacent structures when removing the sublingual gland or because of preservation of the function of the gland.

When conventional marsupialization is undertaken, the wound margins tend to be in contact with each other because of the narrow space and the movement of the tongue and the floor of the mouth. As a result, the lesion

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    Citation Excerpt :

    Marsupialization is the most conservative method of surgical treatment for many surgeons [1,27,31], but recurrences occurring after marsupialization are usually located behind the floor of the mouth. In our days the better technique is removal of the ranula and excision of the involved salivary gland via a cervical approach in order to avoid subsequent recurrence from residual lingual tissue remaining, as many researchers report [5,8,28,31,32]. The tactic of surgically removing the associated salivary gland seems to account for almost zero recurrence, as reported in the literature [6,9,32].

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