Congenital Ranula

A 1-day-old neonate was brought for evaluation of a mass on the floor of her mouth. The swelling was fluctuant and had a bluish tint. No bruit was detected. There was mild tongue elevation but no airway obstruction. Other than this swelling, physical examination findings were normal. The infant was born at term and was breast-feeding.

This child has a congenital ranula, write Robert Steelman, MD, DMD, and Angela Zimmerman, MD, of the Oregon Health and Sciences University. This soft tissue swelling is associated with the ducts from the submaxillary or sublingual glands. Congenital ranulas are rare and are believed to be associated with imperforate salivary ducts or osteal adhesions.^1-3

Treatment is controversial. Some recommend early surgical marsupialization to prevent complications, such as sialadenitis. Others recommend observation with surgical intervention only if airway obstruction or feeding difficulties arise.4-6 Neonatal imperforate ducts may resolve spontaneously with feeding. Such was the case with this child. At 20 months, there has been no recurrence.

REFERENCES:1. Addante RR. Congenital cystic dilatation of the submandibular duct. Oral Surg Oral Med Oral Pathol. 1984;58:656-658.
2. Hoggins GS, Hutton JB. Congenital sublingual cystic swelling due to imperforate salivary ducts. Two case reports. Oral Surg Oral Med Oral Pathol. 1974;37:370-373.
3. Schneiderman H, Nzeako US. Ranula. Consultant. 1996;36:311-312.
4. Rees RT. Congenital ranula. Br Dent J. 1979;146:345-346.
5. Kinirons MJ. Bilateral ranulae in a neonate: a case report. J Oral Med. 1983;38:56-57.
6. Steelman R, Weisse M, Ramadan H. Congenital ranula. Clin Pediatr (Phila). 1998;37:205-206.