Sigismund Paolo Enrico, Bozzato Alessandro, Schumann Mariano, Koch Michael, Iro Heinrich, Zenk Johannes
Department of Specialized Surgical Sciences, Università degli Studi di Milano, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.
J Oral Maxillofac Surg. 2013 Mar;71(3):538-44. doi: 10.1016/j.joms.2012.07.042. Epub 2012 Sep 23.
The aim of the present study was to evaluate the long-term results in the authors' department in the management of patients with oral and plunging ranulas. A specific diagnostic and therapeutic approach is suggested based on these data and data from the literature.
A retrospective analysis of 65 patients with a final diagnosis of ranula was carried out. The medical records were evaluated for the principal demographic, clinical, diagnostic, and therapeutic data. Statistical analysis was used to compare outcomes of the different treatments.
Treatments that included complete sublingual gland excision were associated with the lowest recurrence rate (3.6%), followed by partial sublingual gland excision (9.1%), marsupialization (13%), and ranula excision (36.7%). Nine patients (13.8%) had recurrences. A statistically significant difference was observed (P = .01) in the recurrence rate between complete sublingual gland excision and ranula excision alone. Complications developed in 7 patients (10.8%). Ultrasonography performed in all patients showed an intimate relation among the cyst, mylohyoid muscle, and sublingual gland. Dehiscence of the mylohyoid muscle was noted in some cases.
The surgical experience in the authors' department confirms the different treatments that are offered for ranula. Sublingual gland excision should be the preferred treatment, but marsupialization may be useful as an alternative minimally invasive procedure, with a success rate higher than 85% and no risk of increased complications if revision surgery is needed. Ultrasound is the recommended diagnostic tool, in addition to the clinical examination, for the differential diagnosis and during follow-up.
本研究旨在评估作者所在科室治疗口腔及舌下腺囊肿患者的长期效果。基于这些数据以及文献数据，提出了一种特定的诊断和治疗方法。
对65例最终诊断为舌下腺囊肿的患者进行回顾性分析。评估病历中的主要人口统计学、临床、诊断和治疗数据。采用统计分析比较不同治疗方法的结果。
包括完整舌下腺切除的治疗方法复发率最低（3.6%），其次是部分舌下腺切除（9.1%）、袋形缝合术（13%）和舌下腺囊肿切除术（36.7%）。9例患者（13.8%）出现复发。完整舌下腺切除与单纯舌下腺囊肿切除的复发率之间存在统计学显著差异（P = 0.01）。7例患者（10.8%）出现并发症。对所有患者进行的超声检查显示囊肿、颏舌骨肌和舌下腺之间关系密切。部分病例发现颏舌骨肌裂开。
作者所在科室的手术经验证实了针对舌下腺囊肿的不同治疗方法。舌下腺切除应是首选治疗方法，但袋形缝合术作为一种替代性微创手术可能有用，成功率高于85%，且如果需要进行翻修手术，不会增加并发症风险。除临床检查外，超声是推荐用于鉴别诊断和随访的诊断工具。
