From the Department of Radiology and Research Institute of Radiology (K.H.R., J.H.L., J.Y.L., S.R.C., M.S.C., H.W.K., Y.J.C., J.H.B.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
Department of Radiology (K.H.R.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea.
AJNR Am J Neuroradiol. 2017 Sep;38(9):1794-1798. doi: 10.3174/ajnr.A5292. Epub 2017 Jun 29.
Surgical excision of an affected sublingual gland for treatment of a ranula can carry a potential of a nerve damage or postoperative complications. However, there have been little studies about effective minimally invasive therapeutic method, yet. Our aim was to evaluate the efficacy and safety of ethanol ablation of ranulas and the clinicoradiologic factors that can predict outcome.
This retrospective study evaluated 23 patients with ranulas treated by percutaneous ethanol ablation. Treatment outcome was assessed in 20 patients followed for at least 6 months. The duration of symptoms before ethanol ablation, pretreatment volume, and parapharyngeal extension on sonography and/or CT were correlated with the outcome. The Mann-Whitney test and Fisher exact test were used for comparison of the factors according to the outcome.
The study evaluated 14 males and 9 females with a median age of 26 years (range, 3-41 years). Among 20 patients who were followed for at least 6 months (median, 20 months; range, 6-73 months), 9 patients (45%) demonstrated complete disappearance of the ranulas and 11 (55%) showed an incomplete response. When the patients were divided according to the duration of symptoms before ethanol ablation, the complete response rate was significantly higher in patients with ≤12 months of symptoms (73%, 8/11) than that in others (11%, 1/9) ( = .010). Pretreatment volume and parapharyngeal extension were not significantly different between the 2 groups.
Ethanol ablation is a safe and noninvasive treatment technique for ranulas with a significantly better outcome in patients with ≤12 months of symptoms. Therefore, it could be considered an alternative nonsurgical approach for ranulas with recent onset of symptoms.
手术切除舌下腺以治疗口外型舌下腺囊肿可能会导致神经损伤或术后并发症。然而，目前针对有效的微创治疗方法的研究甚少。本研究旨在评估乙醇消融术治疗口外型舌下腺囊肿的疗效和安全性，以及预测疗效的临床和影像学因素。
本回顾性研究纳入了 23 例行经皮乙醇消融术治疗的口外型舌下腺囊肿患者。对至少随访 6 个月的 20 例患者进行治疗效果评估。将乙醇消融术前症状持续时间、术前体积以及超声和/或 CT 所示咽旁间隙延伸程度与治疗效果进行相关性分析。根据治疗效果，采用 Mann-Whitney 检验和 Fisher 确切概率法比较各因素。
本研究共纳入 14 例男性和 9 例女性患者，中位年龄为 26 岁（范围，3-41 岁）。20 例至少随访 6 个月（中位随访时间为 20 个月；范围，6-73 个月）的患者中，9 例（45%）囊肿完全消失，11 例（55%）囊肿未完全消失。根据乙醇消融术前症状持续时间将患者进行分组，症状持续时间≤12 个月的患者完全缓解率（73%，8/11）显著高于症状持续时间＞12 个月的患者（11%，1/9）（ =.010）。两组患者的术前体积和咽旁间隙延伸程度无显著差异。
乙醇消融术是一种安全、非侵入性的治疗技术，对于症状持续时间≤12 个月的患者，其疗效显著更好。因此，对于症状新近出现的口外型舌下腺囊肿，乙醇消融术可作为一种替代的非手术治疗方法。
