42408 Excision of sublingual salivary cyst (ranula)

Name of the Procedure:

Excision of Sublingual Salivary Cyst (Ranula)

Summary

In this procedure, a surgeon removes a cyst (called a ranula) from beneath the tongue. Ranulas are mucus-filled sacs that form due to blockages in the sublingual salivary glands.

Purpose

The procedure addresses the problem of a ranula, which can cause swelling, discomfort, difficulty speaking, swallowing, and drooling. Removing the cyst aims to alleviate these symptoms and prevent recurrence.

Indications

• Persistent swelling under the tongue
• Difficulty in swallowing or speaking
• Discomfort or pain in the mouth
• Recurrent infections or obstruction caused by the cyst

Preparation

• Patients are usually advised to fast for a certain period before the procedure.
• Medications may need to be adjusted; for instance, blood thinners might be stopped temporarily.
• Pre-operative imaging or ultrasound might be done to assess the cyst.

Procedure Description

1. The patient is given local or general anesthesia.
2. The surgeon makes an incision in the floor of the mouth to access the ranula.
3. The cyst is carefully excised, ensuring all tissue is removed to prevent recurrence.
4. The incision is sutured closed.

Tools used include scalpels, scissors, and specialized oral surgical instruments. The procedure usually involves using either local or general anesthesia.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

This procedure is usually performed in a hospital or outpatient surgical center.

Personnel

• Surgeon (typically an oral and maxillofacial surgeon)
• Anesthesiologist or nurse anesthetist
• Surgical nurses or assistants

Risks and Complications

• Infection at the surgical site
• Bleeding
• Recurrence of the ranula
• Damage to surrounding tissues
• Temporary or permanent changes in sensation or movement of the tongue

Benefits

• Alleviation of symptoms such as swelling, discomfort, and difficulty swallowing.
• Prevent recurrence of the cyst.
• Improved oral function and comfort.

Recovery

• Patients are usually monitored for a few hours after the procedure.
• Pain and swelling are managed with medication.
• Soft diet and good oral hygiene are recommended during recovery.
• Sutures, if not dissolvable, will be removed in a follow-up visit.
• Recovery time is generally about 1 to 2 weeks.

Alternatives

• Aspiration: Draining the cyst, but the recurrence rate is high.
• Marsupialization: Creating a small permanent opening to drain the cyst.
• Pros: Less invasive than excision.
• Cons: Higher chance of recurrence compared to complete excision.

Patient Experience

• During the procedure, depending on the anesthesia, the patient might be fully asleep or awake but numb in the area.
• Post-procedure discomfort is typically managed with prescribed pain medication.
• Swelling and tenderness are common but gradually subside over a few days.
• Patients are advised to follow care instructions to promote healing and minimize complications.