Department of Oral and Maxillofacial Surgery, Guy's, King's and St. Thomas' Hospitals, London, UK.
Int J Oral Maxillofac Surg. 2013 Nov;42(11):1469-74. doi: 10.1016/j.ijom.2013.03.019. Epub 2013 May 29.
Plunging ranulas arise when a simple ranula extends beyond the floor of the mouth into the neck. Diagnosis is difficult even with modern imaging techniques as they mimic other neck lesions, and traditional treatment involves enucleation of the cyst from the neck. Despite this invasive surgery they tend to recur. We describe a less invasive approach to treatment and review the diagnostic pitfalls. From 2002 to 2011, eight patients presented with a plunging ranula. They were split into two groups: those for whom an incorrect diagnosis was made and those where a less invasive treatment approach was employed. Three patients were misdiagnosed with cervical lymphangioma and had inappropriately invasive surgery. Five patients with established plunging ranulas were treated using an intraoral approach alone, eliminating the need for a cervical incision. Misdiagnosis of a plunging ranula leads to extensive and unnecessary surgery. We propose an algorithm to simplify investigation that employs a low threshold for fine-needle aspiration cytology. The cases presented indicate that these lesions can be managed by a less invasive procedure than currently practised.
当单纯的舌下腺囊肿延伸到颈部时，就会出现坠入式舌下腺囊肿。即使使用现代成像技术，诊断也很困难，因为它们类似于其他颈部病变，传统的治疗方法是从颈部切除囊肿。尽管进行了这种侵入性手术，但它们往往会复发。我们描述了一种侵袭性较小的治疗方法，并回顾了诊断陷阱。从 2002 年到 2011 年，8 名患者出现了坠入式舌下腺囊肿。他们被分为两组：一组误诊为颈淋巴管瘤并接受了不适当的侵入性手术，另一组则采用了侵袭性较小的治疗方法。5 名确诊为坠入式舌下腺囊肿的患者采用单纯口腔内入路治疗，无需行颈部切口。对坠入式舌下腺囊肿的误诊导致了广泛而不必要的手术。我们提出了一种简化检查的算法，该算法对细针穿刺细胞学检查的门槛较低。所提出的病例表明，这些病变可以通过比目前更具侵袭性的手术方法进行治疗。
