Rare Case of Plunging Ranula with Parapharyngeal Extension and Absent Submandibular Gland: Excision by Transcervical Approach - Abstract
Plunging ranula extending into parapharyngeal space till the skull base with associated
absence of submandibular gland is a rare finding. Transcervical approach for its excision is a
challenging procedure in view of limited exposure and presence of important neurovascular
structures in the field. We present a clinical case of a left sided plunging ranula extending into the parapharyngeal space till skull base in a 19 year old male who presented to a tertiary care hospital with complaints of slowly increasing swelling in neck and oral cavity for duration of six months. Ultrasound neck revealed well defined heterogeneously hypoechoic collection in left submandibular region. Contrast enhanced computed tomography revealed a non-enhancing, cystic mass involving left submandibular space extending into left parapharyngeal space till skull base and absent left submandibular gland. Ranula measuring 10cm*6cm was excised in to by tanscervical approach without damage to any neurovascular structure. Histopathology was consistent with low ranula. Patient is in follow up for past six months without any recurrence.