Plunging new depths for the treatment of ranulas
Reviewed by Adam Shakir

Within our scope of practice, we encounter a number of salivary gland pathologies, including the sublingual gland. Clinical signs are often subtle, and even with meticulous surgical management, morbidity can easily occur. Textbooks advocate excision of the gland as the definitive treatment. This series of 15 patients describes treatment with a suture technique performed as an outpatient under local anaesthesia, in a two-stage process. The authors state that they have modified a historical Chinese technique. During the first visit, the intra-oral ranula is needle aspirated, and the patient asked to re-attend 48 hours later. At the second visit, a silk suture is placed around the re-accumulated, but smaller, ranula. The intention is to strangulate the ranula and cause fibrosis of the feeding duct, preventing reaccumulation. In time, the silk suture extrudes and is swallowed. They describe two patients of the 15 who did not respond to this treatment and went on to formal gland removal. 

Minimally invasive treatment of oral ranulae: adaption to an old technique.
Goodson A, Payne K, George K, McGurk M.
BRITISH JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY
2015;53:332-335.