A small ranula is a benign, fluid-filled cyst that develops on the floor of the mouth. It originates from a salivary gland, typically the sublingual gland, when saliva leaks into the surrounding soft tissues. These growths are not cancerous.
Causes and Physical Characteristics
A small ranula forms when there is a blockage or trauma to a salivary gland duct, leading to saliva pooling in the nearby connective tissue. This can occur due to an injury to the mouth, such as biting the cheek or a direct impact, or sometimes without any known cause.
A small ranula appears as a soft, movable, dome-shaped swelling on the floor of the mouth, usually to one side of the frenulum (the tissue connecting the tongue to the floor of the mouth). It often has a translucent or bluish hue, resembling the belly of a frog. Symptoms are often minimal; it is often painless and may only be noticed as a subtle lump under the tongue.
Diagnosis and When to See a Doctor
A healthcare provider, such as a dentist or doctor, can diagnose a ranula through a visual and physical examination of the mouth. They will observe the appearance and location of the swelling. For small, straightforward ranulas, imaging tests like CT scans, MRIs, or ultrasounds are not needed, though they might be used to confirm the diagnosis or rule out other conditions.
While small ranulas may not always require immediate medical attention if they are asymptomatic and not growing, it is advisable to see a doctor if the ranula increases in size, becomes painful, or interferes with daily activities. Seeking medical advice is also recommended if the ranula affects eating, swallowing, or speaking.
Treatment Options for Small Ranulas
For small ranulas that do not cause any symptoms, a common approach is observation, often referred to as “watchful waiting.” Many of these cysts may resolve spontaneously without intervention. If a small ranula persists or begins to cause issues, treatment becomes necessary.
One treatment option is marsupialization, a procedure where a surgeon creates an opening in the cyst and stitches the edges of the incision to the surrounding oral tissue. This allows the trapped saliva to drain continuously into the mouth, which helps prevent the cyst from refilling. Another approach for recurrent cases or larger ranulas is surgical excision, which involves removing the cyst along with the affected salivary gland, usually the sublingual gland, to minimize the chance of recurrence. Treatment outcomes for ranulas are positive, especially when the underlying gland is addressed.