How to Diagnose Ranula

A ranula is a cystic tumor on the bottom of the tongue or floor of the mouth. They are usually caused by trauma to a minor salivary duct and occasionally saliva obstruction. Cervical ranulas result from the accumulation of mucus in the fascia of the neck while oral ranulas develop from mucus accumulating above the mylohyoid muscle. The following steps will show how to diagnose a ranula.

Instructions

• 1

  Observe the general symptoms of a ranula. A cervical ranula appears as an asymptomatic neck mass and an oral ranula may interfere with breathing, speech, chewing and swallowing. A large oral ranula also may interfere with saliva flow from the submandibular gland.

• 2

  Palpate a cervical ranula. The mass should be freely mobile and painless with the skin overlaying it usually intact. A cervical ranula may not be well-defined and can fluctuate in size.

• 3

  Examine an oral ranula. They do not blanch on compression and are unilaterally blue to translucent. The causative salivary gland may be difficult to identify if the ranula is large.

• 4

  Take a biopsy of a cervical ranula. It may show amorphous material with only occasional inflammatory cells. The accumulation of mucin separates the epithelium from the submucosa.

• 5

  Determine the histology of the suspect cyst. It will have a well-delineated cavity containing free mucin. The cavity wall is granulated without an epithelial lining and composed of fibroblasts and small caliber vessels. Muciphages from both types of ranula can be detected with mucicarmine staining.