Ranula — MFDS Part 1 MCQ

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ModerateOral Surgery PrinciplesRanulaMFDS Part 1

A 24-year-old patient has a painless, fluctuant swelling in the floor of the mouth. Imaging shows a cystic lesion extending through a defect in the mylohyoid into the submandibular space, consistent with a plunging ranula. Which salivary gland is the usual source of the leaked mucus?

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Correct answer: B — Sublingual gland

The correct answer is B, the sublingual gland. A ranula is usually a mucus-extravasation pseudocyst caused by leakage from the sublingual gland, commonly through a damaged duct of Rivinus. A plunging ranula tracks through or around the mylohyoid into the neck. Although its cervical component may occupy the submandibular space, it does not usually arise from the submandibular gland, making C the key distractor. Parotid leakage occurs near the cheek or parotid region, while mucoceles arising from minor salivary glands are most common on the lip and do not constitute ranulas; palatal swellings also require a different differential diagnosis.

Reference: Cambridge University Hospitals NHS Foundation Trust, Oral and Maxillofacial Surgery, Removal of sublingual salivary gland, approved 16 July 2025. https://www.cuh.nhs.uk/patient-information/removal-of-sublingual-salivary-gland/