Etiology • Obstruction of the sublingual (usually) or submandibular sali-
vary gland by a sialolith or by trauma • Secondary to obstruction, extravasation of saliva into the soft
tissue of the floor of the mouth
Clinical Presentation • Unilateral, fluctuant, soft tissue mass on the floor of the mouth • Usually has a bluish, slightly translucent quality • When above the mylohyoid muscle, presentation is intraoral. • If extravasation extends below the mylohyoid muscle, a plung-
ing ranula forms. • Occlusal radiographs may demonstrate a suspected sialolith.
vary gland by a sialolith or by trauma • Secondary to obstruction, extravasation of saliva into the soft
tissue of the floor of the mouth
Clinical Presentation • Unilateral, fluctuant, soft tissue mass on the floor of the mouth • Usually has a bluish, slightly translucent quality • When above the mylohyoid muscle, presentation is intraoral. • If extravasation extends below the mylohyoid muscle, a plung-
ing ranula forms. • Occlusal radiographs may demonstrate a suspected sialolith.
Diagnosis • Demonstration of sialolith • Soft tissue imaging (T 2
-weighted magnetic resonance image) • Aspiration of mucinous salivary fluid • Excised tissue with granulation tissue lining around mucin pool
Differential Diagnosis • Dermoid cyst • Salivary gland tumor • Soft tissue tumor • Cystic hygroma • Thymic cyst
Treatment • Marsupialization as an initial procedure • Excision of the involved gland (extravasation type) • Sialolithectomy (in obstructive type)
Prognosis • No recurrence with sialadenectomy • Recurrence risk with sialolithectomy secondary to duct scarring or reformation of stone