Plunging Ranula — ORE Part 1 MCQ

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ModerateOral SurgeryPlunging RanulaORE Part 1

A patient presents with a sublingual swelling that has plunged through the mylohyoid muscle into the submandibular space. It is soft and fluctuant. What is this condition called?

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Correct answer: E — Plunging ranula

A plunging ranula is a mucous extravasation cyst of the sublingual gland that extends through or behind the mylohyoid muscle into the submandibular space, presenting as a soft, fluctuant swelling in the neck or submental region. This is exactly as described in the stem. The key discriminating feature is the passage through the mylohyoid muscle, which separates the sublingual space (above) from the submandibular space (below). Ludwig angina is an acute, painful cellulitis, not a cystic lesion. Submandibular sialadenitis is acute inflammation of the gland itself. Dermoid cyst occurs in the midline floor of mouth and has different aetiology. Sublingual abscess would be acutely inflamed and infected, not a painless fluctuant cyst.

Reference: Ascending and plunging ranula in a pediatric patient. PubMed. https://pubmed.ncbi.nlm.nih.gov/19467424/ (2009)