Lip

Mucous Retention Cyst

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Mucous Retention Cyst, Mucocele

  • Epidemiology
  1. Most common in children and young adults
  • Causes
  1. Local Trauma (e.g. biting lip)
  • Pathophysiology
  1. Results from Traumatic rupture of Salivary Glands
  2. Results in mucin spillage into lower lip
  • Signs
  1. Benign lesion 1-2 cm diameter
  2. Round, regular, translucent or bluish Nodule
  3. Distribution
    1. Typically occurs on inside of lower lip
    2. May occur in any oral surface with Salivary Glands
  4. Consistency
    1. Early lesions are fluctuant
    2. Later lesions are firm and fibrotic
  • Differential Diagnosis
  1. Lip Neoplasm
  2. Lip Aneurysm
  3. Dermoid Cyst
  • Management
  • Removal
  1. Local techniques
    1. Indicated in lesions that are typical for Mucocele
    2. Anesthesia with Local Lidocaine with Epinephrine at the base of the lesion
    3. Technique 1
      1. Shave the lesion with scalpel, removing the top 50-75% but leaving the base
      2. Obtain Hemostasis
    4. Technique 2
      1. Place 4-0 or 5-0 Nylon Suture through the Mucocele, creating 2 holes in its surface
      2. Tie the Suture and remove in 5-7 days
    5. Other techniques
      1. Cryotherapy
      2. Electrocautery
  2. Surgical excision
    1. Indicated for suspicious lesions (refer to otolaryngology, oral facial surgery or dermatology)
    2. Include minor glands at base
    3. Send for pathology to rule-out neoplasia
  • References
  1. Warrington (2020) Crit Dec Emerg Med 34(1): 13