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Diagnostic difficulties of plunging ranula: case series

Published online by Cambridge University Press:  09 March 2012

R Jain*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Middlemore Hospital, Auckland, New Zealand
R P Morton
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Middlemore Hospital, Auckland, New Zealand
Z Ahmad
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Middlemore Hospital, Auckland, New Zealand
*
Address for correspondence: Dr Ravi Jain, c/o Leigh Somerville, Department Secretary, Department of Otolaryngology – Head and Neck Surgery, Counties-Manukau DHB, PO Box 98743, South Auckland Mail Centre, Manukau City, New Zealand E-mail: ravijainnz@gmail.com

Abstract

Objectives:

To evaluate common pitfalls in diagnosing complicated plunging ranula, either due to misidentification of plunging ranula or alternative pathology (i.e. false negatives or false positives, respectively).

Methods:

A review of cases of plunging ranula seen in Middlemore Hospital, New Zealand, was performed. Diagnostically uncertain cases were identified and reviewed, taking particular note of clinical, radiological and surgical findings.

Results:

From our database, 12 cases were found to have had a complicated diagnosis of plunging ranula. Ten cases were false negatives: four were treated as abscesses, four as simple cysts, one as a thyroglossal cyst and one as a cystic hygroma. Two cases were false positives: one was found to be a thyroglossal cyst and the other a lipoma.

Conclusion:

The diagnosis of plunging ranula is usually straightforward, with simple surgical management. Misdiagnosis can lead to recurrence of symptoms and inappropriate management, with the associated risks, complications and frustrations of surgery.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2012

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References

1Morton, RP, Ahmad, Z, Jain, P. Plunging ranula: congenital or acquired? Otolaryngol Head Neck Surg 2010;142:104–7CrossRefGoogle ScholarPubMed
2Jain, P, Jain, R, Morton, RP, Ahmad, Z. Plunging ranulas: high-resolution ultrasound for diagnosis and surgical management. Eur Radiol 2010;20:1442–9CrossRefGoogle ScholarPubMed
3Samant, S, Morton, RP, Ahmad, Z. Surgery for plunging ranula: the lesson not yet learned? Eur Arch Otorhinolaryngol 2011;268:1513–18CrossRefGoogle Scholar
4Huang, SF, Liao, CT, Chin, SC, Chen, IH. Transoral approach for plunging ranula – 10-year experience. Laryngoscope 2010;120:53–7CrossRefGoogle Scholar
5Croskerry, P. The importance of cognitive errors in diagnosis and strategies to minimize them. Acad Med 2003;78:775–80CrossRefGoogle Scholar
6Miller, MB, Rao, VM, Tom, BM. Cystic masses of the head and neck: pitfalls in CT and MR interpretation. Am J Roentgenol 1992;159:601–7CrossRefGoogle ScholarPubMed