Ranula

Background

Salivary glands: #1 Parotid gland, #2 Submandibular gland, #3 Sublingual gland.

• A type of mucocele of the sublingual gland

Clinical Features

Ranula under tongue

Mostly seen in young children and adolescents

• Swelling in floor of mouth to side of frenulum (typically unilateral)
  • Color is pale blue with semi transparent appearance
  • Surface is smooth and mucous membrane is mobile over the swelling
  • Size varies from 1 – 5 cm in diameter
  • Tenderness is absent
  • Positive fluctuation and transillumination (if performed)

Differential Diagnosis

Facial Swelling

• Buccal space infections
• Dental problems
• Canine space infection
• Facial cellulitis
• Herpes zoster
• Masticator space infections
• Maxillofacial trauma
• Neoplasm
• Parapharyngeal space infection
• Salivary gland diagnoses
  • Parotitis
    • Bilateral parotitis
    • Suppurative parotitis
    • Viral parotitis (Mumps)
  • Ranula
  • Sialoadenitis
  • Sialolithiasis
• Superior vena cava syndrome

Evaluation

Workup

• None required

Diagnosis

• Typically a clinical diagnosis

Management

• Does not typically require ED treatment

Disposition

• Outpatient follow up with ENT