Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, USA.
Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, USA.
Neuroradiol J. 2021 Oct;34(5):449-455. doi: 10.1177/19714009211008790. Epub 2021 Apr 8.
A ranula is a mucus-filled salivary pseudocyst that forms in the floor of the mouth, commonly arising from the sublingual or submandibular salivary glands following obstruction or trauma. Complete excision of the injured gland and removal of the cyst content is the first-choice therapy, but has the potential for complications related to injury to nearby structures. As such, minimally invasive approaches such as percutaneous sclerotherapy have been investigated. We aim to contribute to the literature by assessing the efficacy and safety of our technique through our experience with 18 patients over the last decade.
This retrospective study evaluated 18 patients with intraoral and plunging ranulas treated by percutaneous bleomycin ablation. The primary endpoint was the treatment result. Secondary endpoints included bleomycin dosage and complications.
The study evaluated 12 males and six females with a median age of 23.5 years (range 13-39 years). At a final follow-up of at least 2 months (6.5±5.5 months), four patients demonstrated complete response (22%) and 14 patients demonstrated residual presence, recurrence, or regrowth of the lesion (78%). There were no statistically significant associations between outcomes and history of prior treatment, number of treatments, and size or type of ranula. No complications were noted.
Our findings indicate that bleomycin, while safe for use in various head and neck malformations, is of limited utility in ranula therapy when the offending gland is not addressed primarily.
舌下囊肿是一种充满黏液的唾液假性囊肿，常发生于口底，多由舌下或颌下唾液腺阻塞或外伤引起。完整切除受损腺体并清除囊内容物是首选治疗方法，但有损伤邻近结构相关并发症的风险。因此，已经研究了微创方法，如经皮硬化疗法。我们旨在通过过去十年治疗的 18 例患者的经验，为文献做出贡献，评估我们技术的疗效和安全性。
本回顾性研究评估了 18 例经皮平阳霉素消融治疗的口腔内和浸入性舌下囊肿患者。主要终点是治疗结果。次要终点包括平阳霉素剂量和并发症。
研究评估了 12 名男性和 6 名女性，中位年龄为 23.5 岁（范围 13-39 岁）。在至少 2 个月（6.5±5.5 个月）的最终随访中，4 例患者完全缓解（22%），14 例患者病变仍存在、复发或生长（78%）。治疗结果与既往治疗史、治疗次数、囊肿大小或类型之间无统计学显著相关性。未观察到任何并发症。
我们的研究结果表明，平阳霉素在治疗各种头颈部畸形时是安全的，但在主要未解决病变腺体的情况下，对舌下囊肿的治疗效果有限。
