Ranula

What is a ranula?

A ranula is a cyst that can form on the floor of your mouth, under your tongue. It’s filled with saliva (spit), and it’s the result of a blocked or damaged salivary gland.

A healthy salivary gland empties saliva directly into your mouth. A blocked or damaged salivary gland may cause saliva to drain into surrounding tissues instead. As a result, saliva continues to build up until a cyst or “bubble” develops.

There are two types of ranulas: simple and plunging. A simple ranula causes swelling that’s limited to the floor of your mouth. A plunging ranula happens when the swelling grows down into your neck.

Is a ranula serious?

Ranulas aren’t dangerous or cancerous, and some may even go away on their own. But, some ranulas grow so large that they interfere with breathing or swallowing. In these cases, treatment is necessary.

Who gets ranulas?

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

Ranulas are also more common in people from certain parts of the world, such as the Maori people of New Zealand and Pacific Island Polynesians.

How common are ranulas?

While ranulas are one of the most common salivary gland disorders, they’re not that common overall. In the U.S., there are 0.2 cases out of every 1000 people.

What are the symptoms of a ranula?

Ranula symptoms may include:

• A clear or bluish lump on the floor of your mouth. This is the most common symptom of a ranula under your tongue.
• Swelling that goes up and down. Ranulas usually start out around 2 to 3 inches in diameter. Sometimes they empty, but then fill up again — and they can grow larger over time. If you have a plunging ranula, you may only notice neck swelling.

If a ranula continues to grow in size, it can lead to:

• Difficulty swallowing.
• Difficulty breathing due to compression of your trachea (windpipe).

Ranulas usually aren’t painful. But, if enough fluid builds up, some people may experience discomfort from the pressure.

What causes a ranula?

A ranula forms when saliva flows into the tissue around your salivary gland instead of in your mouth. There are different reasons why this can happen. A ranula might be the result of:

• A blocked or damaged salivary gland.
• Injury or trauma to your mouth.

In some instances, there’s no obvious cause.

Are ranulas contagious?

No. Since bacteria, viruses or fungi don’t cause ranulas, they’re not contagious.

How is a ranula diagnosed?

Healthcare providers usually suspect a ranula due to the location in your mouth. The area of swelling is often easy to spot. To confirm your diagnosis, your provider may request imaging tests, including:

• A CT (computed tomography) scan.
• MRI.
• Ultrasound.

How is a ranula treated?

While some simple ranulas go away on their own over time, many need treatment. Ranula treatment depends on the size of the cyst and the severity of your symptoms.

Your healthcare provider may recommend needle aspiration, incision and draining, marsupialization or surgical removal of the ranula.

Needle aspiration

Your healthcare provider uses a needle to withdraw the fluid from the ranula. Because this procedure doesn’t repair the underlying issue, the ranula may eventually reappear.

Incision and draining

Your provider makes a small incision (cut) to drain the ranula. Like needle aspiration, this procedure doesn’t repair the underlying problem, so, recurrence (return) is possible.

Marsupialization

This type of ranula treatment involves making a small incision in the cyst and suturing (stitching) the edges to keep it open. This allows the ranula to drain freely on its own.

Surgical removal of ranula

During this procedure, your surgeon removes the ranula as well as the salivary gland that’s causing the issue. If they remove the cyst but not the gland, a new ranula could form later. Surgical removal of the ranula and the gland offers the best chance at a permanent solution.

Are there side effects or complications regarding ranula treatment?

There’s always a risk that ranulas will come back after treatment, though recurrence (return) is rare following complete salivary gland removal. Recurrence is more common in people who undergo needle aspiration, incision and draining and marsupialization.

It’s normal to experience some side effects after ranula treatment, including:

• Mild discomfort.
• Swelling.
• Bruising.

Complications after salivary gland removal are rare, but they can occur. Call your healthcare provider if you develop:

• Heavy bleeding from the surgical site.
• Signs of infection, including drainage, chills or fever over 101°F.
• Numbness in your tongue.
• Pain that doesn’t improve with medication.

How long does it take to recover from ranula treatment?

If your healthcare provider drains the ranula, it should only take a couple of days to heal. But, if you have surgery to remove the ranula and your salivary gland, then recovery takes about one to two weeks.

Your provider will give you a list of detailed post-operative instructions. Follow these guidelines closely.

How can I reduce my risk for ranulas?

There’s no known way to prevent ranulas because they occur from trauma, or sometimes, without cause.

Do ranulas go away?

In some cases, ranulas can go away on their own without treatment. But, if you have a ranula that increases in size or interferes with breathing and swallowing, treatment is necessary.

What should I expect if I have a ranula?

If you have an enlarged ranula that’s interfering with breathing or swallowing, talk to your healthcare provider. They can help determine what type of treatment is best.

Ranulas usually aren’t serious and most people recover quickly following treatment.

When can I go back to work or school?

If you’ve had surgery to remove the ranula and your salivary gland, you’ll probably need to take about one week off of work or school. If you had a less invasive procedure, such as needle aspiration, you’ll be able to return to normal routines in a day or two.

When should I see my healthcare provider?

Call your healthcare provider any time you notice lumps, bumps or other abnormalities under your tongue. Your provider may monitor your condition. Or, depending on the size of the ranula, they may recommend treatment.

A note from Cleveland Clinic

A ranula is a clear or bluish cyst that can form under your tongue. It can happen spontaneously, or as a result of trauma or injury to your mouth. Ranulas aren’t cancerous or dangerous. But, if you have a ranula that becomes enlarged or starts to spread, it’s important to seek medical care right away.