From the Research
The most effective treatment for a ranula is complete surgical excision of the ranula along with the associated sublingual gland, which has the lowest recurrence rate of approximately 1-2% 1. This approach is considered the gold standard treatment, although it carries higher risks of complications, including damage to the lingual nerve or submandibular duct.
- Other treatment options include:
- Marsupialization, which involves creating an opening in the ranula and suturing the edges to allow continuous drainage, often effective for simple oral ranulas 2.
- Sclerotherapy using OK-432 (picibanil) or other sclerosing agents, which can be an effective non-surgical alternative, particularly for plunging ranulas or in patients who are poor surgical candidates 3.
- Watchful waiting, which may be appropriate for very small, asymptomatic ranulas, as some may resolve spontaneously 4.
- Recurrence rates vary by procedure, with simple aspiration having the highest recurrence (approximately 70-100%), marsupialization around 20-30%, and complete excision the lowest 5, 1.
- The choice of treatment should be individualized based on the ranula's characteristics, patient preferences, and the surgeon's experience.
- A recent study found that simple transoral excision of the sublingual gland with ranula drainage is sufficient for treatment of plunging ranulas, with low rates of complications and ranula recurrence 1.