What causes ranulas?

Updated: Oct 19, 2020
  • Author: Catherine M Flaitz, DDS, MS; Chief Editor: Jeff Burgess, DDS, MSD  more...
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Most ranulas are the result of escaped mucus from an injured excretory duct, while ductal obstruction of primarily the sublingual gland and rarely the submandibular gland is a less common cause. This obstruction is often due to a sialolith or mucus plug; however, chronic inflammation or infection with periductal scarring, trauma, ductal stenosis, ductal hypoplasia or agenesis, and neoplasia are other causes of ranula formation.

Anatomic variation of ductal system of the sublingual gland may increase the risk for the development of a ranula. In particular, this risk appears to be increased when the Bartholin duct is connected to and empties into the Wharton duct. [4]

Isolated case reports have identified Sjögren syndrome and sarcoidosis as contributing to the development of these reactive lesions. In addition, HIV infection may increase the risk of developing a ranula in children and adults. [5, 6]

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