Department of Neuroscience and Reproductive and Odontostomatological Sciences, "Federico II" University of Naples, 80131 Naples, Italy.
Postgraduate School of Orthodontics, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168 Rome, Italy.
Int J Environ Res Public Health. 2023 Jan 29;20(3):2398. doi: 10.3390/ijerph20032398.
Ranula is a rare and benign extravasation mucocele that is clinically characterized by asymptomatic sublingual or submandibular masses. Surgical excision is considered the most effective treatment approach, but it has been associated with high invasiveness and several complications (hemorrhage, damage to Wharton's duct, and lingual nerve injury). Over the past decade, more conservative therapies have been rapidly disseminated into clinical practice to seek a more effective and less traumatic approach for young patients. In this report, an 8-year-old female with an asymptomatic, recurrent sublingual ranula was treated using a conservative approach with marsupialization and an intracystic injection of a plaque remover (Hybenx gel). After incision of the cystic dome, Hybenx gel was applied into the cystic lumen for 20 seconds and then aspirated; next, the area was rinsed thoroughly with sterile saline solution before suturing. Ultrasound re-evaluation at 10 months and intraoral clinical examination at 24 months confirmed the absence of relapse. Our results support the hypothesis that marsupialization combined with intracystic injection of Hybenx gel could be an encouraging conservative treatment alternative for recurrent sublingual ranula in children. Further randomized controlled trials are needed to test this hypothesis.
舌下腺囊肿是一种罕见的良性外渗性黏液囊肿，临床上表现为无症状的舌下或下颌下肿块。手术切除被认为是最有效的治疗方法，但它与高侵袭性和多种并发症（出血、沃顿管损伤和舌神经损伤）有关。在过去的十年中，更多的保守治疗方法已迅速应用于临床实践，以寻求对年轻患者更有效、创伤更小的方法。本报告介绍了一例 8 岁女性，她患有无症状、复发性舌下腺囊肿，采用了保守治疗方法，即造袋术和囊内注射斑块清除剂（Hybenx 凝胶）。在切开囊顶后，将 Hybenx 凝胶应用于囊腔 20 秒，然后吸出；然后，用无菌生理盐水彻底冲洗该区域，再进行缝合。10 个月后的超声复查和 24 个月的口腔临床检查均证实无复发。我们的结果支持这样一种假设，即造袋术联合囊内注射 Hybenx 凝胶可能是儿童复发性舌下腺囊肿一种有前途的保守治疗选择。需要进一步的随机对照试验来验证这一假设。
