A ranula is a type of mucocele that occurs specifically in the floor of the mouth, typically involving the sublingual salivary gland. It forms when saliva leaks into surrounding tissues due to damage or blockage of a salivary duct. This leads to a buildup of mucus, creating a soft, swollen area under the tongue. Ranulas often appear as bluish, translucent swellings and may gradually increase in size. Because of their location, they can interfere with speaking, swallowing, or tongue movement if they become large. In some cases, the fluid collection can extend beyond the floor of the mouth into the neck, which is referred to as a plunging ranula. If this process continues, the swelling may persist or recur, especially if the underlying gland or duct issue is not resolved. The size and symptoms can vary depending on the extent of the lesion.
UnderstandingÂ
Ranula
Clinical Significance
Can lead to swelling under the tongue, difficulty speaking or swallowing, recurrence, and extension into neck tissues in more advanced cases.
Common Causes
Trauma to salivary ducts, blockage of sublingual gland ducts, salivary gland damage, irritation, unknown (idiopathic) factors
Signs & Symptoms
Soft swelling under tongue, bluish or translucent appearance, painless or mild discomfort, difficulty speaking or swallowing if large, possible neck swelling (plunging ranula)
How It's Detected
Clinical exam, visual inspection, patient history, imaging (ultrasound, CT, or MRI) for deeper or plunging cases
Treatment Options
Monitoring for small lesions, surgical removal of ranula and associated gland, marsupialization, drainage (temporary), no treatment in select mild cases
Benefits to Treatment
Resolves swelling, improves oral function, reduces recurrence, prevents progression or extension into surrounding tissues
Prevention
Avoid oral trauma, manage habits that injure oral tissues, regular dental visits, early evaluation of oral swellings
Frequently Asked Questions
What is the difference between a ranula and a mucocele?
A ranula is a specific type of mucocele that occurs in the floor of the mouth, usually involving the sublingual gland. In many cases, mucoceles appear on the lips or cheeks, while ranulas are located under the tongue. Because of their location, ranulas may be larger and more likely to affect speech or swallowing.
Are ranulas painful?
Ranulas are usually not painful. In many cases, they present as a painless swelling under the tongue. However, if the lesion becomes large, it may cause discomfort or interfere with normal oral functions such as speaking or swallowing.
Can a ranula go away on its own?
In some cases, a ranula may temporarily reduce in size if it ruptures, but it often returns if the underlying salivary gland issue is not resolved. Persistent or recurrent ranulas typically require treatment to prevent ongoing swelling.
What is the most common treatment for a ranula?
The most common treatment is surgical removal of the ranula along with the affected sublingual gland. This approach helps reduce the risk of recurrence. Other options, such as marsupialization, may be used in certain cases depending on the size and extent.
What is a plunging ranula?
A plunging ranula occurs when the fluid extends beyond the floor of the mouth into the neck tissues. In many cases, this results in visible swelling in the neck without a prominent oral lesion. Imaging is often used to evaluate the extent, and treatment typically involves surgical management.