A ranula is a type of cyst or swelling that forms in the mouth, typically found on the floor of the mouth, beneath the tongue. This fluid-filled sac arises when saliva leaks from a damaged salivary gland into the surrounding tissues. While often not serious, a ranula can sometimes grow large enough to cause concern or interfere with daily activities.
What is a Ranula?
A ranula presents as a soft, often translucent, and bluish-tinted swelling, resembling a frog’s underbelly, which is how it got its name from the Latin word “rana” meaning frog. The swelling is usually painless unless it becomes infected. These cysts originate from the major salivary glands, most often the sublingual gland, when saliva escapes due to trauma or obstruction.
There are two primary classifications of ranulas based on their location and extent. A “simple” or “oral” ranula is confined to the floor of the mouth. In contrast, a “plunging” or “cervical” ranula occurs when the leaked saliva extends deeper, dissecting through or around muscles in the floor of the mouth, and creating a swelling in the neck. This type is rarer and can present as a neck mass, sometimes without an obvious oral component.
Do Ranulas Go Away on Their Own?
Ranulas can sometimes resolve spontaneously, meaning they may disappear without any medical intervention. This spontaneous resolution often occurs if the cyst ruptures and drains its fluid, or if the body reabsorbs the leaked saliva. In some instances, the fluid collection might empty into the mouth, only to slowly refill over weeks. While self-resolution is possible, it is not guaranteed and can be unpredictable.
The likelihood of a ranula resolving on its own can depend on certain factors. Smaller ranulas are more prone to self-healing and may resolve sooner than larger ones. However, even if a ranula temporarily shrinks or disappears, there is a possibility it may reappear because the underlying issue of the damaged salivary gland or duct remains. While many ranulas resolve spontaneously, a procedure is often needed for definitive treatment.
When to Consult a Healthcare Professional
It is advisable to consult a healthcare professional if you notice any persistent or growing swelling under your tongue or in your neck that might be a ranula. While ranulas are not dangerous or cancerous, a medical evaluation is important to confirm the diagnosis and rule out other, potentially more serious conditions. A physician can diagnose a ranula based on a physical examination, but imaging tests like ultrasound, CT scans, or MRI may be used to determine its extent.
Medical attention is particularly recommended if the ranula increases in size, causes discomfort, or begins to interfere with normal activities such as speaking, eating, or swallowing. A very large ranula can even affect breathing. If there are signs of infection, such as fever, chills, or increased pain, prompt medical care is also necessary. Seeking professional advice ensures appropriate management and discussion of potential treatment options.
Available Treatment Options
When a ranula does not resolve on its own or causes symptoms, various medical and surgical treatments are available. One less invasive approach is needle aspiration, where a healthcare provider uses a needle to withdraw the fluid from the ranula. However, this method is often temporary, as the cyst may reappear in a majority of cases because the underlying cause is not addressed.
Surgical interventions are more definitive. Marsupialization is a common procedure where the surgeon makes an incision in the ranula and sutures the edges of the cyst to the surrounding oral lining, creating a permanent opening or “pouch” that allows continuous drainage. While it is a widely reported treatment, simple marsupialization can have high recurrence rates if the opening closes prematurely. Modified micro-marsupialization techniques have shown improved success rates and lower recurrence.
For more persistent or larger ranulas, especially plunging types, surgical excision of the ranula along with the affected salivary gland is often recommended. Removing the source of the mucus significantly reduces the risk of recurrence. The choice of treatment depends on the ranula’s size, type, and the severity of symptoms, with procedures being safe and effective in resolving the condition.