Ranula

A ranula is a fluid-filled cyst on the floor of your mouth, under your tongue. It forms when saliva (spit) from a salivary gland leaks into tissue around the gland. Eventually, saliva builds up and creates a squishy lump on the floor of your mouth or swelling in your neck. You may get a ranula (pronounced “ra-NOO-luh”) if something blocks or damages the gland so saliva can’t flow into your mouth.

Ranulas aren’t cancer or a serious medical issue. Some go away without treatment. But the lump under your tongue may change the way you talk or eat. Some can grow so large that they make it hard to breathe or swallow. In that case, you may need treatment to drain fluid from the ranula or to remove it.

Ranula types

There are two types:

• Simple ranulas stay under your tongue and only affect the floor of your mouth.
• Plunging ranulas expand by growing down under your mouth and into your neck.

Symptoms of ranulas

Symptoms may include:

• A clear or bluish lump on the floor of your mouth. Most ranulas measure about 2 to 3 inches before they cause symptoms.
• Swelling that comes and goes. Ranulas may get bigger as saliva collects in the cyst and then shrink when saliva drains out. But they can fill up again.

Ranulas usually aren’t painful. But the sensation of a lump under your tongue or swelling in your neck may make you uncomfortable. A large ranula can push your tongue out of place. That can affect how you talk or eat. For example, you may talk with a lisp or eat very slowly.

Ranula causes

This condition may develop when something blocks or damages your salivary gland. But sometimes, there’s no clear cause.

Risk factors

People of any age and sex can get ranulas. But they’re more common in children and adults ages 20 to 40.

Complications

A large ranula can affect your breathing if it presses on your windpipe. It can make it hard for you to swallow.

How doctors diagnose a ranula

A healthcare provider will ask about your symptoms. They’ll look under your tongue and check your neck for swelling. They may request imaging tests, including:

• CT scan
• MRI scan
• Ultrasound

How are ranulas treated?

Your treatment will depend on your symptoms and the size of the ranula. Some go away on their own. But you may need treatment if the ranula makes it hard to breathe or swallow. Procedures include:

• Needle aspiration: Your provider uses a needle to drain fluid from the ranula.
• Incision and draining: They make a small cut in the cyst so fluid can flow out.
• Marsupialization: This procedure involves making a cut in the ranula. Your provider then stitches the cut’s edges. This holds the cut open so fluid drains naturally.
• Surgery: Your provider removes the ranula and the salivary gland that causes the issue.

Recovery

Recovery depends on what treatment you had. For example, a cut to drain a ranula should only take a couple of days to heal. It may take one to two weeks to recover from surgery to remove your salivary gland and the ranula.

When should I see my healthcare provider?

Contact a healthcare provider if you notice a lump under your tongue or swelling in your neck — even if it comes and goes.

If you had surgery to remove a ranula and salivary gland, you should contact your provider if you experience:

• Heavy bleeding
• Numbness in your tongue
• Pain that doesn’t get better with medication
• Surgical wound infection symptoms, like fever over 101 degrees Fahrenheit (38.33 degrees Celsius) or pus draining from the surgery site

What can I expect if I have a ranula?

This isn’t a serious medical condition. Some go away without treatment. In some cases, treatment to drain a ranula takes care of your symptoms. But a ranula may come back. Surgery is the only permanent solution.

Is a ranula a type of sexually transmitted infection (STI)?

No. Ranulas happen when something blocks or damages your salivary gland. They aren’t caused by STIs.

What is the difference between a ranula and a mucocele?

The term “mucocele” refers to any type of mucus-filled cyst in the inside of your mouth. A ranula is a specific type of mucocele.