CYSTS OF THE ORAL SOFT TISSUE
A mucocele is a mucous containing cyst, formed by minor salivary glands.
There are two types of distinct entities
(i) The retention cyst which is lined by epithelium, and, (ii) mucous extravasation cyst which does not have a definitive lining. It is therefore, not always possible to enucleate the cyst out.
They are painless swellings generally found on the lower lip, they are small in size from 2 mm to 2 cm. Sudden rupture of the mucocele with the mucous flowing out is common.
If possible enucleation should be attempted.
Incision is made along both the sides of the mucocele.
Care being taken not to rupture it.
The wound is closed by interrupted suturing.
When enucleation is not possible, an incision should be made through the mucosa into the lesion, the mucous flows out.
Then the incision line is spread and the underlying mucous glands are identified and excised.
The incision is sutured.
It is a large mucocele present in the floor of the mouth.
It is thin walled, bluish, transparent in appearance. It ispresent under the tongue, therefore sometimes the tongue is raised or displaced. Once punctured the mucous flows out, and the ranula becomes flaccid, but it refills as soon as the puncture point heals.
Marsupialization or surgical removal of the cyst along with the gland is the treatment of choice. For marsupialization the mucous membrane overlying the ranula is cut, allowing the mucous to flow out.
Then these cut margins are turned outwards and stitched to the lingual mucosa, thus exposing the epithelium of the ranula to the oral cavity, allowing for the healing to take place.