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      Marsupialización modificada de ránula gigante intraoral: reporte de caso Translated title: Modified marsupialisation of a giant intraoral ranula: Case report

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          Abstract

          La ránula intraoral es una enfermedad benigna seudoquística de extravasación que tiene su origen en las glándulas salivales sublinguales. Es una entidad poco prevalente. Es más frecuente en niños y adolescentes, con características clínicas propias que la diferencian de otras entidades de la boca. Su tratamiento es quirúrgico y varias técnicas han sido descritas en la literatura: marsupialización simple y modificada, enucleación de la lesión, extirpación de la glándula junto con enucleación de la ránula. Si bien la extirpación de la glándula junto con la enucleación de la lesión es el tratamiento definitivo radical y más aceptado, la marsupialización modificada puede ser útil como alternativa de tratamiento quirúrgico conservador en casos de ránulas intraorales gigantes, disminuyendo los riesgos de morbilidad quirúrgica y presentando bajos índices de recurrencia, mientras su aplicación sea cuidadosa. El siguiente reporte de caso describe el manejo clínico de forma quirúrgica conservadora mediante marsupialización modificada, con un seguimiento de 12 meses sin signos de recidiva.

          Translated abstract

          The intraoral ranula is a benign pseudo-cystic extravasation with its origin in the sublingual salivary glands. It is an infrequent disease. It is more common in children and adolescents, with its own clinical characteristics that differentiate it from other entities in the mouth. The treatment for this condition is surgical, and several techniques have been described in the literature: simple and modified marsupialisation, enucleation of the lesion, and removal of the gland with enucleation of the ranula. While the removal of the gland with enucleation of the lesion is the widely accepted radical and definitive treatment, marsupialisation may be useful as an alternative to conservative surgical treatment in cases of giant intraoral ranula, reducing the risk of surgical morbidity, and presenting with low rates of recurrence, while its application should be performed with care. The case is presented that describes the conservative surgical treatment with marsupialisation in its clinical management, with a 12 months follow up without signs of recurrence.

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          Most cited references16

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          Mucoceles and ranulas.

          H Baurmash (2003)
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            Clinical review of 580 ranulas.

            The purpose of this paper was to compare clinical features among 3 patterns of ranula and the recurrence rates of each when treated by different surgical methods. A retrospective review of clinical and pathologic records in 580 ranulas was undertaken. Ranulas were classified into 3 clinical types according to sites of the primary swelling: oral ranula, plunging ranula, and mixed ranula. Information was collected on age at presentation, sex, history of onset, sites of swelling, surgical methods, histological findings, and outcome of treatment. Ranula was most prevalent in the second decade of life and slightly more common in females (male to female ratio of 1:1.2), but a distinct male predilection was noted for the plunging ranula (male to female ratio of 1:0.74). Oral ranula was most commonly involved in the left side (left to right ratio of 1:0.62), while the plunging and mixed ranula were commonly involved in the right side (left to right ratio of 1:1.38, 1:1.16 respectively). In the plunging ranula group, there were more patients who had the history more than 6 months. The recurrence rates of ranulas were not related to swelling patterns and surgical approaches, but intimately related to the methods of surgical procedures. The recurrent rates for marsupialization, excision of ranula, and excision of the sublingual gland or gland combined with lesion were 66.67%, 57.69%, and 1.20%, respectively. Three patterns of ranula have similar clinical and histopathologic findings, although plunging ranula has some different clinical features. Removal of the sublingual gland via an intraoral approach is necessary in the management of various clinical patterns of the ranula. Recurrence rates of ranulas of any type are excessive unless the involved sublingual gland is removed.
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              Ranulas--mucoceles of the oral cavity: experience in 26 children.

              Ranulas or mucoceles of the floor of the mouth are uncommon but do occur in approximately 5% of patients undergoing submandibular duct relocation for the management of uncontrollable sialorrhea. Review of our experience with 26 patients over 12 years ending in 1986 substantiated a concept previously advocated by other authors that ranulas are usually extravasation pseudocysts developing after disruption of sublingual gland elements, and that excision of the ipsilateral sublingual gland is the management approach of choice.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                piro
                Revista clínica de periodoncia, implantología y rehabilitación oral
                Rev. Clin. Periodoncia Implantol. Rehabil. Oral
                Sociedad de Periodoncia de Chile.; Sociedad de Implantología Oral de Chile.; Sociedad de Prótesis y Rehabilitación Oral de Chile. (Santiago, , Chile )
                0719-0107
                December 2016
                : 9
                : 3
                : 217-221
                Affiliations
                [03] Valencia orgnameUniversidad de Valencia orgdiv1Facultad de Medicina y Odontología orgdiv2Departamento de Estomatología España
                [01] Valdivia orgnameUniversidad San Sebastián orgdiv1Facultad de Odontología Chile
                [04] orgnameHospital Base Valdivia Chile
                [02] Valencia orgnameUniversidad de Valencia orgdiv1Facultad de Medicina y Odontología España
                Article
                S0719-01072016000300001
                10.1016/j.piro.2015.06.008
                16a8c09e-99a9-4cb5-aad8-2688c903dc83

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 14 December 2014
                : 21 June 2015
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 16, Pages: 5
                Product

                SciELO Chile


                Ránula sublingual,Marsupialización,Glándulas salivales,Sublingual ranula,Marsupialization,Salivary glands

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