The use of the modified micromarsupialization technique in the treatment of bilateral ranula: A clinical case report




Rânula; Sublingual gland; Oral pathology.


The phenomena of mucus extraversion results from a (mechanical) trauma of the excretory ducts of a salivary gland, which leads to an accumulation of mucin in the underlying connective tissue of the ducts. These results are classified as mucoceles and ranulas depending on their location. Treatment is surgical, ranging from marsupialization to permanent lesion removal in addition to other decompression techniques. The objective of this article is to report a clinical case in which a bilateral ranula was treated using the modified micromarsupialization technique with a cotton thread suture in size 0. Female patient with 84 years of age presenting leucoderma and hypertension was admitted into the Emergency Room of the Hospital da Restauração Governador Paulo Guerra in Recife, Pernambuco, Brazil, presenting an asymptomatic bilateral volume increase in the oral floor region and mild dysphagia. According to the clinical assessments (anamnesis, general and loco-regional physical examinations) and complementary evaluations, a pathological lesion resulting from the leakage of mucus into the adjacent tissues called a ranula was obtained as a diagnosis  in which it presented a satisfactory clinical response with the micromarsupialization treatment modified with cotton thread suture size 0. The modified micromarsupialization technique for the treatment of a granula showed success and possess the advantage of being a simple procedure reducing operative times. This procedure is also minimally invasive and shows less risk of damage to the surrounding anatomical structures.


Alqhtani, N. R., & Krishnan, A. (2011). Ranula: pathogenesis and management–A review. IJD. International Journal of Dentistry, 11(1), 49-54.

de Castro, T. F., Quinto, J. H. S., Iwaki, L. C. V., Veltrini, V. C., Iwaki Filho, L., & de Souza Tolentino, E. (2019). A ultrassonografia como ferramenta no diagnóstico do lipoma em região maxilofacial: relato de caso. Revista uningá, 56(S3), 11-17.

Freitas, S. E. N. D., Furuse, C. F., Biazolla, E. R., & Andrade Sobrinho, J. (2004). Rânula: técnica de marsupialização: relato de caso clínico. Rev. Odontol. Araçatuba (Impr.), 53-56.

Guzmán-Letelier, M., Crisosto-Jara, C., Reyes-Marislao, B., Peñarrocha-Diago, M., & Peñarrocha-Oltra, D. (2016). Marsupialización modificada de ránula gigante intraoral: reporte de caso. Revista clínica de periodoncia, implantología y rehabilitación oral, 9(3), 217-221.

Hegde, S., Bubna, K., & Rao, D. (2017). Management of ranula in a child by modified micro-marsupialization technique: a case report. Journal of Clinical Pediatric Dentistry, 41(4), 305-307.

Jiménez, D. R., Fernández, I. P., & Arce, D. Z. (2017). Ránula, alternativas de tratamiento quirúrgico versus no quirúrgico. Odovtos-International Journal of Dental Sciences, 18(1E), 15-28.

Kamalakaran, A., Jayaraman, B., Balasubramaniam, S., Thirunavukkarasu, R., & Ramakrishnan, B. (2018). Plunging ranula in a 78-year-old male–a rare case report. Journal of clinical and experimental dentistry, 10(1), e92.

Kokong, D., Iduh, A., Chukwu, I., Mugu, J., Nuhu, S., & Augustine, S. (2017). Ranula: current concept of pathophysiologic basis and surgical management options. World Journal of Surgery, 41(6), 1476-1481.

Lawal, A. O., Adisa, A. O., Kolude, B., Adeyemi, B. F., & Olajide, M. A. (2013). A review of 413 salivary gland tumours in the head and neck region. Journal of clinical and experimental dentistry, 5(5), e218.

Leal, R. M., & Braulio, I. T. (2014). Marsupialização em rânula: relato de caso clínico. Arq Bras Odontol, 10(1), 15-20.

Matondkar, S. P., Yavagal, C., & Mandroli, P. S. (2019). Modified micro-marsupialization as an alternative treatment for the management of ranulas in children. National journal of maxillofacial surgery, 10(1), 95.

Moraes, P. D. C., Teixeira, R. G., Thomaz, L. A., Junqueira, J. L. C., & Oliveira, L. B. (2015). Cryosurgery for the treatment of pediatric plunging ranula: a conservative management. RGO-Revista Gaúcha de Odontologia, 63(4), 492-495.

Negromonte Gonçalves, K. K., dos Santos, M. S., de Ângelis Alves Silva, J., & Lira Correia, A. V. (2019). Rânula mergulhante extensa em paciente pediátrico tratado com micromarsupialização: relato de caso. RSBO: Revista Sul-Brasileira de Odontologia, 16(2).

Neville, B. W., Damm, D. D., Allen, C. M., & Chi, A. C. (2016). Patologia Oral e Maxilofacial (4a ed.), Elsevier.

Noleto, J. W., Israel, M., Mourão, C. F., & de Sá Bonfim, T. (2010). Rânula mergulhante tratada por meio de marsupialização: relato de caso. Revista Brasileira de Odontologia, 67(1), 60.

Oliveira, J. C. S. D., Garcia-Júnior, I. R., Camelo, J., Rabêlo, L. R. S., & Bastos, E. G. (2015). Rânula mergulhante recidivante: relato de caso. Revista de Cirurgia e Traumatologia Buco-maxilo-facial, 15(2), 27-32.

Peterson, L. J. (2000). Cirurgia Oral e Maxilofacial Contemporânea (3a ed.). Guanabara Koogan.

Rocha, A. L., Basílio, J. M. B. S., Amaral, M. B. F., & Mesquita, R. A. (2013). Tratamento da mucocele com a técnica da micromarsupialização modificada. Revista da Associação Paulista de Cirurgiões Dentistas, 67(4), 268-271.

Shah, J. S., & Asrani, V. K. (2017). Clinical applications of ultrasonography in diagnosing head and neck swellings. Journal of Oral and Maxillofacial Radiology, 5(1), 7.

Tommasi, M. H. (2013). Diagnóstico em Patologia Bucal (4a ed.), Elsevier.



How to Cite

GONZALEZ, A. A.; NASCIMENTO, A. S.; LIMA, A. C. A. de A.; LAGO, C. A. P. do; BRITO, F. R. C.; SANTOS, G. M. de A.; PINTO, J. V. S.; CABRAL, L. P.; SILVA FILHO, N. J. da; PINTO, P. S.; SILVA, R. G. M. da; MARINHO NETO, W. F. . The use of the modified micromarsupialization technique in the treatment of bilateral ranula: A clinical case report. Research, Society and Development, [S. l.], v. 10, n. 4, p. e21610414032, 2021. DOI: 10.33448/rsd-v10i4.14032. Disponível em: Acesso em: 3 mar. 2024.



Health Sciences