Sclerotherapy for the ranula with Bleomycin: technical considerations and preliminary experience

Abstract Ranula is a mucous cyst that occurs in the floor of the mouth. It can be classified into three types based on origins: accessory (minor) salivary gland cysts, Rivini duct cysts, and sublingual gland cysts. Because of the anatomical characteristics, surgical resection of the cysts not only carries the risk of damaging adjacent tissues but also has a high recurrence rate. Intralesional injection of sclerotherapy may be a better alternative treatment. We summarized 65 cases of ranula treated with intralesional injections of bleomycin(BML). According to the origin of the ranula, 60 cases were from the accessory (minor) salivary glands or the ducts of Rivini, and 5 cases were from the body of the sublingual gland. The results showed that 60 cases of ranula from the accessory (minor) salivary glands and Rivini ducts were 100% cured during the follow-up period. The median number of injections for all patients was 1.16. All 5 cases of ranula from the sublingual gland did not wholly recover. This study confirmed that BLM intralesional injection is a safe and effective treatment modality for cysts from oral floor accessory (minor) salivary glands or the ducts of Rivini rather than sublingual gland cysts. Therefore, before treatment, it is necessary to determine the type and origin of the cyst by characterizing its morphology to ensure the effectiveness of the treatment.