II. Epidemiology
- Most common in children and young adults
III. Definitions
- Mucocele (Mucous Retention Cyst, typically of the lip)
- Traumatic rupture of small Salivary Glands with spillage of mucin (typically within the lower lip)
- Ranula (Mucocele of the mouth floor)
- Mucocele of the oropharyngeal floor
- Most often due to submaxillary or Sublingual Gland duct obstruction
- Plunging Ranula extends beyond the mylohyoid Muscle
IV. Causes
- Local Trauma (e.g. biting lip)
V. Pathophysiology
- Results from Traumatic rupture of Salivary Glands
- Results in mucin spillage into lower lip
VI. Signs
- Benign lesion 1-2 cm diameter
- Round, regular, translucent or bluish Nodule
- Distribution
- Typically occurs on inside of lower lip
- May occur in any oral surface with Salivary Glands
- Consistency
- Early lesions are fluctuant
- Later lesions are firm and fibrotic
VII. Differential Diagnosis
- Lip Neoplasm
- Lip Aneurysm
- Dermoid Cyst
VIII. Management
- Small Mucoceles resolve spontaneously without treatment
- Local treatment techniques
- Indicated in lesions that are typical for Mucocele
- Anesthesia with Local Lidocaine with Epinephrine at the base of the lesion
- Technique 1
- Shave the lesion with scalpel, removing the top 50-75% but leaving the base
- Obtain Hemostasis
- Technique 2
- Place 4-0 or 5-0 Nylon Suture through the Mucocele, creating 2 holes in its surface
- Tie the Suture and remove in 5-7 days
- Other techniques
- Cryotherapy
- Electrocautery
- Surgical excision
- Indicated for suspicious lesions (refer to otolaryngology, oral facial surgery or dermatology)
- Also excise minor Salivary Glands at Mucocele base
- Send for pathology to rule-out neoplasia
IX. References
- Warrington (2020) Crit Dec Emerg Med 34(1): 13
- Randall (2022) Am Fam Physician 105(4): 369-76 [PubMed]