Geurts T W, van den Akker H P, Balm A J
Afd. KNO-heelkunde, Academisch Medisch Centrum/Universiteit van Amsterdam, Amsterdam.
Ned Tijdschr Geneeskd. 2004 Feb 21;148(8):388-91.
Three patients, 2 men aged 21 and 39 years, respectively, and 1 woman aged 29 years, presented with a unilateral swelling of the neck, with no accompanying symptoms. In the youngest man the diagnosis of a 'plunging ranula' was made after repeated fine needle aspiration yielded viscous yellowish mucus with a high amylase content. In the oldest man the diagnosis was made during the operation and in the woman the diagnosis was finally made after two surgical explorations in the neck. In all 3, no recurrence occurred after removal of the involved salivary glands. A cervical ranula is an extension of a pseudocyst of the glandula sublingualis. Important clues for the diagnosis of a 'plunging ranula' are: the simultaneous presence of a ranula in the floor of the mouth (or a history of one), a characteristic cystic mass in the submandibular space with an extension into the sublingual space on CT and/or MRI, and the aspiration of amylase-containing mucus. Excision of the sublingual gland as the source of salivary leakage is the therapy of choice in a case of 'plunging ranula', with drainage of mucus from the ranula into the oral cavity. As the 'plunging ranula' represents a pseudocyst without an epithelial lining, excision is not indicated.
三名患者，分别为两名男性，年龄分别为21岁和39岁，以及一名29岁女性，均表现为颈部单侧肿胀，无伴随症状。最年轻的男性经反复细针穿刺抽出含高淀粉酶含量的粘性淡黄色黏液后，诊断为“坠入性舌下囊肿”。最年长的男性在手术中确诊，而女性在颈部进行了两次手术探查后最终确诊。所有3例患者在切除受累唾液腺后均未复发。颈部舌下囊肿是舌下腺假性囊肿的延伸。“坠入性舌下囊肿”诊断的重要线索包括：口腔底部同时存在舌下囊肿（或有相关病史）、下颌下间隙有特征性囊性肿块且在CT和/或MRI上延伸至舌下间隙，以及抽出含淀粉酶的黏液。对于“坠入性舌下囊肿”，切除作为唾液漏出源的舌下腺是首选治疗方法，同时将舌下囊肿内的黏液引流至口腔。由于“坠入性舌下囊肿”是一个无上皮衬里的假性囊肿，无需切除。
