Abstract：
OBJECTIVE: Despite advancements in imaging techniques and cytological analysis, plunging ranula remains a challenging surgical, radiologic, and pathologic phenomenon. Of the 18 patients we evaluated at our institution, we highlight three cases that illustrate the high rate of misleading imaging and cytological results when assessing plunging ranula.
METHODS: Imaging results, biopsy findings, operative techniques, and pathological reports were reviewed from patients who had either a preoperative or postoperative diagnosis of ranula and underwent surgery by a single head and neck surgeon at a tertiary care center.
RESULTS: Of the 18 identified patients, computed tomography was correct on preoperative imaging 73% of the time and magnetic resonance imaging was correct on preoperative imaging 71% of the time. Two patients underwent preoperative ultrasound and their ultrasound reports did not accurately diagnose the presence of a ranula. Two patients underwent preoperative fine needle aspiration biopsy due to inconclusive preoperative imaging, in which results suggested either a ranula or epidermal cyst. Both ultimately did not match the final pathology. Three of eighteen patients (17%) underwent an inappropriate initial surgery due to incorrect imaging diagnoses and/or biopsy findings.
CONCLUSIONS: Despite use of preoperative modalities to distinguish plunging ranula from other cystic floor of mouth lesions, surgeons must be aware that no workup modality is fully precise. The potential for revision surgery must be included in all preoperative discussions for presumed plunging ranula.
METHODS: 4 Laryngoscope, 134:2689-2696, 2024.
METHODS: Imaging results, biopsy findings, operative techniques, and pathological reports were reviewed from patients who had either a preoperative or postoperative diagnosis of ranula and underwent surgery by a single head and neck surgeon at a tertiary care center.
RESULTS: Of the 18 identified patients, computed tomography was correct on preoperative imaging 73% of the time and magnetic resonance imaging was correct on preoperative imaging 71% of the time. Two patients underwent preoperative ultrasound and their ultrasound reports did not accurately diagnose the presence of a ranula. Two patients underwent preoperative fine needle aspiration biopsy due to inconclusive preoperative imaging, in which results suggested either a ranula or epidermal cyst. Both ultimately did not match the final pathology. Three of eighteen patients (17%) underwent an inappropriate initial surgery due to incorrect imaging diagnoses and/or biopsy findings.
CONCLUSIONS: Despite use of preoperative modalities to distinguish plunging ranula from other cystic floor of mouth lesions, surgeons must be aware that no workup modality is fully precise. The potential for revision surgery must be included in all preoperative discussions for presumed plunging ranula.
METHODS: 4 Laryngoscope, 134:2689-2696, 2024.
摘要：
目的：尽管在成像技术和细胞学分析方面取得了进步，暴跌的ranula仍然是一个具有挑战性的手术，放射学,和病理现象。在我们机构评估的18名患者中，我们重点介绍了3个案例,这些案例说明了在评估下下的ranula时,成像和细胞学结果的误导性发生率很高.
方法：成像结果，活检结果，手术技术，我们对术前或术后诊断为ranula并由三级护理中心的一名头颈部外科医生进行手术的患者的病理报告进行了审查.
结果：在确定的18名患者中，73%的术前成像时计算机断层扫描正确,71%的术前成像时磁共振成像正确.两名患者接受了术前超声检查，他们的超声报告未准确诊断出是否存在ranula。由于术前影像学不确定，两名患者接受了术前细针穿刺活检，其中结果提示为毛囊或表皮囊肿。两者最终都不匹配最终病理。由于不正确的影像学诊断和/或活检结果，18例患者中有3例（17％）接受了不适当的初始手术。
结论：尽管使用了术前方法来区分骤降的淋巴结和其他口腔囊底病变，外科医生必须意识到，没有任何检查方式是完全精确的。所有术前讨论中都必须包括翻修手术的可能性，以推测其是否会暴跌。
方法：4喉镜，2024.
方法：成像结果，活检结果，手术技术，我们对术前或术后诊断为ranula并由三级护理中心的一名头颈部外科医生进行手术的患者的病理报告进行了审查.
结果：在确定的18名患者中，73%的术前成像时计算机断层扫描正确,71%的术前成像时磁共振成像正确.两名患者接受了术前超声检查，他们的超声报告未准确诊断出是否存在ranula。由于术前影像学不确定，两名患者接受了术前细针穿刺活检，其中结果提示为毛囊或表皮囊肿。两者最终都不匹配最终病理。由于不正确的影像学诊断和/或活检结果，18例患者中有3例（17％）接受了不适当的初始手术。
结论：尽管使用了术前方法来区分骤降的淋巴结和其他口腔囊底病变，外科医生必须意识到，没有任何检查方式是完全精确的。所有术前讨论中都必须包括翻修手术的可能性，以推测其是否会暴跌。
方法：4喉镜，2024.
