Ranulas are clear or bluish-coloured fluid-filled cysts caused by a blocked salivary gland in the mouth. It is a slow-growing benign cyst that is seen on the floor of the mouth and under the tongue, which varies in size. While some ranula cysts remain small, others enlarge and cause problems.

A healthy salivary gland empties saliva directly into the mouth, while a damaged one may cause saliva to drain into surrounding tissues. Thereby salvia continues to build up until a cyst or bubble develops.
Woman with Ranula

Simple and plunging are two types of ranula. A simple ranula results in swelling that’s seen in the bottom of the mouth while a plunging ranula occurs when swelling grows down into your neck.

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The primary sign of this condition is a visible, translucent growth on the bottom of the mouth, and it usually doesn’t cause any pain, so you may not have observed it until the cyst grows. Even the swelling is confined to the sublingual gland, which is the smallest of the three paired salivary glands surrounding the throat and mouth.

A diving or plunging ranula is another type that develops when a small ranula ruptures. This triggers the formation of a pseudocyst that spreads into the neck via a damaged myeloid muscle, which is a group of muscles that regulates the tongue. This results in the development of mass in the submandibular space (facial space of the head and neck).

Difficulty swallowing, speaking issue, and tracheal compression are some of the other symptoms associated with plunging ranula.


In most cases, the exact cause of the ranula is unknown and the swelling happens naturally. In other cases, ranula develops after a trauma or an injury to the floor of the mouth. An injury can damage the ducts that move saliva from the salivary gland into the mouth, resulting in blockage. When the salvia cannot get properly eliminated, it accumulates in the gland and forms a dome-shaped cyst. Biting the lower lip or getting hit in the face are some incidences of trauma.

While plunging or diving ranulas are usually caused by a quickly growing simple ranula that ruptures.

How Is A Ranula Diagnosed?

A small ranula does cause any symptoms and may not require any treatment. But an enlarged ranula needs medical attention, as there’s a risk of lesion rupturing. An enlarged ranula will hinder your normal speech, swallowing, eating, or breathing pattern. Generally, your physician may diagnose it based on the appearance and location of the cyst. Your physician may recommend certain imaging tests to evaluate the extent of swelling or to confirm that symptoms are caused by a ranula.

Imaging tests recommended by your physician include:

These tests can also characterize a ranula from conditions with similar symptoms and features, such as an abscess, a dermoid cyst, or a branchial cleft cyst.


Small ranulas that don’t cause any issues may not need any treatment and cysts disappear on their own. But enlarged ranulas need treatment, particularly if swelling impedes’ s swallowing or speaking. Depending on its size, your physician may make a small incision and drain the cyst to reduce swelling. Even if treatment is successful, fluid will accumulate again.

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Needle Aspiration: Your physician with a help of a needle withdraws the fluid from the cyst. However, this procedure doesn’t treat the underlying issue and the ranula may recur later.

Incision And Draining: Your surgeon will make a small incision or cut to drain the ranula. Similar to needle aspiration, this procedure doesn’t repair the underlying problem, hence ranula will eventually reappear.

Marsupialization: In this procedure, the surgeon makes a small incision in the cyst and sutures the edges to let it open, which allows the ranula to drain freely.

Surgical Removal Of Ranula: Your surgeon will remove the ranula as well as the salivary gland, which is causing the problem. If only the cyst is removed but not the gland, a new ranula could appear later. Surgical removal of the ranula and the gland provides the best and permanent solution.

If you experience pain, then your doctor may recommend an intralesional steroid injection into the skin beneath the cyst. The injection not only helps to improve the appearance of the cyst — it may also reduce painful symptoms.