Plunging ranula (掉下的 舌下腫瘤)

· Outpouching of sublingual or minor salivary galnd

· Often 2° to blockage of duct

· Plunging ranula descends through or posterior to mylohyoid

· Painless swelling in floor of mouth and neck, bluish

· High amylase and mucin content

· No epithelial lining

· Differentiate from cystic hygroma as no change in size with valsalva, or decrease with pressure

Treatment

· Excision of ranula only

· Marsupilisation

· Excision of ranula and associated gland

— Lowest recurrence rate

— Need to preserve submandibular duct through mucosal flap (Mastery p314)