CURRENT THERAPY
J Oral Maxillofac Surg
Mucoceles and Ranulas
Harold D. Baurmash, DDS*
Mucoceles, exclusive of the irritation fibroma, are the
most common of the benign soft tissue masses
present in the oral cavity. Mucoceles (muco meaning
mucus and coele meaning cavity), by definition, are
cavities filled with mucus. When in the oral floor, they
are called ranula (rana meaning frog and ula meaning
little) because the swelling resembles the vocal or air
sacs of the frog (Fig 1).
Mucus is the exclusive secretory product of the
accessory (minor) salivary glands and the more prom-
inent product of the sublingual (major) salivary gland.
The mechanisms for mucus cavity development are
extravasation or retention. Extravasation (extra, out-
side; vasa, vessel) is the leakage of fluid from the ducts
or acini into the surrounding tissue, while the much
less common retention phenomenon occurs as a re-
sult of a narrowed ductal opening that cannot ade-
quately accommodate the exit of saliva produced,
leading to ductal dilation and surface swelling.
In the case of the accessory salivary glands, the
extravasation of mucus is the primary cause of muco-
cele formation with physical trauma as the initiating
factor. The one exception is the mucous glands of the
midportion of the posterior hard palate and the adja-
cent soft palate, where a low-grade chronic superfi-
cial irritation can lead to mucoceles of the retention
variety. This is sometimes seen in cases of nicotinic
stomatitis, in which irritation from heat and noxious
tobacco products can result in narrowing of the duc-
tal openings (Fig 2). The majority of retention cysts
develop at the orifices of the major salivary glands.
The exception is the sublingual gland: only the open-
ings of the ducts of Rivini (5 to 15), which service the
superficial portion of the gland, may develop such
cysts.
The pseudocystic mucoceles, regardless of their
location, present as soft, painless swellings ranging
*Retired Clinical Professor of Oral and Maxillofacial Surgery,
Columbia University, School of Dental and Oral Surgery, New York,
NY.
Address correspondence and reprint requests to Dr Baurmash:
4666 Hazleton Lane, Lake Worth, FL 33467; e-mail: hali2533@aol.
com
© 2003 American Association of Oral and Maxillofacial Surgeons
0278-2391/03/6103-0015$30.00/0
doi:10.1053/joms.2003.50074
369
61:369-378, 2003
from deep blue to normal pink in color. The deep
blue color results from tissue cyanosis and vascular
congestion associated with the stretched overlying
tissue and the translucent character of the accumu-
lated fluid beneath. The variation in color depends on
the size of the lesion, its proximity to the surface, and
the elasticity of the overlying tissue. The bluish color
may be subtle when there is reduced elasticity of the
overlying tissue or if it is somewhat distant from the
surface mucosa, but it will become evident after the
initial mucosal incision (Fig 3).
Mucoceles of all of the accessory glands and the
retention cysts of the major glands are rarely larger
than 1.5 cm and they are always superficially posi-
tioned. Conversely, those arising from the deeper
areas of the body of the sublingual gland are generally
significantly larger and can be massive.
Mucous cysts rarely present significant problems.
Discomfort, interference with speech, mastication,
and swallowing, and external swelling depend on size
and location (Fig 4A). In cases of very large sublingual
gland mucoceles, the tongue may compress the ran-
ula to such a degree during eating and swallowing
that there is interference with submandibular salivary
flow. This results in obstructive symptoms and clini-
cal enlargement of the gland (Fig 4B). This has led to
diagnostic confusion in the past, when it was believed
by some that the source of a ranula may be the
submandibular duct. Retention cysts of Wharton’s
duct occur but with a distinct clinical appearance.
The lower lip is by far the most frequent site of the
mucocele because it is the area most often susceptible
to trauma, especially in the cuspid location (Fig 5). It
is not surprising that mucoceles are rarely if ever
found on the upper lip even though it has the same
concentration of mucous glands. The lip is followed
in frequency by the cheek and palate. On occasion,
mucoceles may be seen on the ventral surface of the
tongue involving the glands of Blandin-Nuhn. In most
cases, this results from self-inflicted bite wounds. On
even rarer occasions, the incisal gland in the anterior
oral floor and the retromolar pad area may be in-
volved.
The most common origin of the ranula is the
deeper areas of the body of the sublingual gland,
followed to a lesser degree by the retention cysts from
370
FIGURE 1. A, Large ranula closely resembling the air or vocal sacs of the frog. B, Air or vocals sacs of the frog, which are used for mating calls
with a range of 1 mile.
the ducts of Rivini. Less frequently, retention cysts of
the opening of Wharton’s duct are encountered.
Histopathology of Mucoceles
The extravasation variety consists of a granulation
tissue lining surrounded by a condensation of connec-
FIGURE 2. Retention cyst of the palate secondary to nicotine stoma-
titis. Note the punctate inflammatory areas around the openings of the
adjacent palatal glands.
FIGURE 3. A, Extremely large ranula with only a subtle blue appearance. B, After the mucosal incision, the cystic mass shows a deep blue color.
MUCOCELES AND RANULAS
tive tissue with varying amounts of inflammation and
vascular engorgement. The condensed connective tis-
sue may be mistaken for epithelium (Fig 6). It is not
unusual to find salivary gland tissue in the neighbor-
ing areas. The retention cyst will have a similar ap-
pearance minus adjacent salivary glands. In addition,
remnants of ductal epithelium (columnar or cuboidal)
may be present (Fig 7).
Surgical Technique for the
Management of Accessory Salivary
Gland Mucoceles
LIP, CHEEK, AND PALATE
There are 3 possible approaches to the manage-
ment of mucoceles of the lower lip which also apply
to those in the cheek and palate. The small lesion can
be completely excised, making sure to include the
associated salivary gland tissue as well as any marginal
glands before primary closure. Large mucoceles are
best treated with an unroofing procedure (marsupial-
ization), because excision or dissection would be
HAROLD D. BAURMASH
FIGURE 4. A, With the mouth closed, a slight to moderate swelling
is noted involving the submandibular and submental areas. B, As a
result of the ranula compressing Wharton’s duct, the left submandibular
gland is visible extraorally.
problematic and risk vital structures such as the labial
branch of the mental nerve.
The key to reducing the incidence of recurrence is
to remove any projecting peripheral salivary glands
FIGURE 5. A mucocele of the lower lip in the cuspid area. Evidence
of chronic irritation is the hyperkeratosis and irritation fibroma adjacent
to the mucous cyst.
371
FIGURE 6. Histopathology of the extravasation mucocele with a
granulation tissue lining. Note the vascular engorgement, minimal
inflammation, and salivary gland tissue in the connective tissue cap-
sule.
before the placement of interrupted marginal sutures
whose only purpose is to prevent such projections
into the surgical site. Care should be taken to avoid
injury to the other glands and ducts with the suture
needle because surgical injury to any of the marginal
glands is another cause of recurrence.
The third procedure involves the dissection of the
mucocele along with the servicing mucous glands.
This technique is performed on moderate sized le-
sions. As in the excision technique, all marginal
glands should be removed before primary closure.
The most important requirement is a firm, relatively
thick connective tissue covering; otherwise, the dis-
section will fail, and recurrence is the expected com-
plication. If one suspects thin fibrous walls, unroofing
may be preferable.
Occasionally, physicians may encounter a nonmu-
cous retention cyst in the cheek involving the open-
ing of Stensen’s duct, which will increase in size
FIGURE 7. Histopathology of the retention cyst shows granulation
tissue lining with evidence of remnants of columnar epithelium and
moderate to marked inflammation in the area adjacent to the lumen.
(Reprinted with permission.6)
372
FIGURE 8. A, A retention cyst of Stensen’s duct, which enlarges after salivary stimulation. B, The cyst is unroofed and a lacrimal probe is inserted
into the duct lumen before the duct margins are sutured to the adjacent mucosa.
during eating (Fig 8A). After the entire cyst-like cov-
ering is excised, a lacrimal probe is inserted into the
dilated duct, and the margins of the duct wall are
sutured to the mucosa with fine interrupted gut su-
tures (sialodochoplasty) (Fig 8B). The recommended
follow-up care consists of salivary stimulating foods
(lemon drops, grapefruit, and pickles) and duct dila-
tion using lacrimal probes. Healing is always rapid and
uneventful. Because access may be a problem in the
palate, all surface-prominent mucoceles are best
treated with simple marsupialization with or without
sutures.
TONGUE
The anterior lingual gland, the gland of Blandin-
Nuhn, is located on the inferior surface of the tongue
close to the apex and midline, covered only by thin
mucous membrane. In reality, it is not a single gland
but a compact package of smaller glands that open
with several ducts on its inferior surface.1
The proposed technique for managing moderate to
large cysts of Blandin-Nuhn (Fig 9A) begins with the
placement of a tongue-retracting suture at the tip of
the tongue. The goal of surgery is to completely
unroof the lesion along its entire periphery to visual-
ize and remove all of the glands present. Because the
traction applied to stabilize the tongue tends to mask
or obliterate the outline of the lesion periphery and
the drainage of the mucus will be even more damag-
ing regarding visualization, experts recommend that
immediately after a 1-cm longitudinal incision
through the mucosa, 0.25-inch plain gauze should be
packed into the cavity to restore the original periph-
eral configuration (Fig 9B). The lesion is then un-
roofed and all glandular tissue is removed, leaving a
muscular base (Fig 9C). The mucosa is undermined
and a primary closure performed. Healing without
complication or recurrence should follow. Small mu-
MUCOCELES AND RANULAS
coceles are completely excised and primarily closed.
Healing is rapid and uneventful.
Management of Ranula and Ranula-
Like Lesions in the Oral Floor
Simple marsupialization, the oldest and most
widely reported method of surgical management of
oral ranula, has fallen into disfavor primarily because
of the excessive number of recurrences (61% to 89%)
after it. For this reason, Crysdale et al,2 Catone et al,3
and Bridger et al4 proposed that sublingual gland
removal should be the primary treatment of all ranula.
If simple marsupialization was the only other ap-
proach available, then this conclusion would be irre-
futable.
With our present knowledge concerning the devel-
opment of the ranula, simple marsupialization of rel-
atively large lesions (⬎1.5 cm), which usually origi-
nate from the deeper portions of the sublingual gland,
is a procedure without sound foundation from an
anatomic, mechanical, or histological standpoint.5
The procedure cannot succeed when the origin of the
mucocele is distant from the surface and when the
mucocele is of the extravasational variety with a gran-
ulation tissue lining.
Unroofing this lesion will result in drainage of its
contents, and the inferior compression by the tongue
during function will force the opposing granulation
tissue walls together, leading to rapid healing with
minimum fibrosis. Because this treatment does not
eliminate the source of leakage of the mucus into the
surrounding tissue, one would expect recurrence at
even a higher rate than reported.
There are, however, 2 reasons for reconsidering
sublingual gland removal as primary treatment for the
ranula. First, a number situations present as ranula
that do not arise from the sublingual gland.6 Second,
HAROLD D. BAURMASH
a slight variation to the standard marsupialization pro-
cedure can reduce the incidence of recurrence to
10% to 12%.5
Treating Ranula-Like Lesions Not
Arising From the Body of the
Sublingual Gland
MUCOCELE OF THE INCISAL GLAND
The incisal glands are a small group of mucous
(accessory) glands found on the floor of the oral
cavity behind the lower incisors.1 They are unrelated
and superficial to the sublingual gland. Mucoceles
that develop are treated with unroofing and removal
of all glandular tissue with or without peripheral mar-
gin suturing.
RETENTION CYST OF WHARTON’S DUCT
Retention cysts may present as small (0.5 cm) to
moderately sized (1.5 cm) superficial cyst-like lesions
in the area of the caruncular sublingualis extending
posteriorly along the course of the plica sublingualis
(Fig 10A). In this area, they may simulate retention
cysts of the ducts of Rivini. Examination of the evac-
uated cystic secretions may help to differentiate be-
tween them. The secretion from the sublingual gland
will be more viscous (mostly mucus, with a viscosity
373
FIGURE 9. A, A moderate-sized mucocele from the glands of
Blandin-Nuhn on the left ventral surface of the tongue. B, A longitudinal
incision is made through the wall of the cyst-like mass and 0.25-inch
gauze is packed into the cavity. C, The mucocele is unroofed, and all
of the salivary gland tissue is removed, leaving a muscle base to the
wound.
of 13.4 centipoises) than that of the submandibular
gland (more serous than mucus, with a viscosity of 3.4
centipoises).7 In addition, Wharton’s duct retention
cysts are always associated with some degree of ob-
structive submandibular gland symptoms (gland
swelling during eating). They are never larger than 1.5
cm in contradistinction to the massive ranula that can
result in similar obstructive symptoms.
The procedure consists of unroofing the cyst, in-
serting a wide lacrimal probe into the dilated duct
lumen, and sialodochoplasty (Fig 10B). Postoperative
care consists of food sialogogues (lemon drops and
citrus fruits) and ductal dilation with appropriately
sized probes. Rapid healing and the formation of a
new patent opening is the result.
SUBMANDIBULAR DUCT INJURY WITH SALIVARY
FLUID LEAKAGE
On occasion, an iatrogenic injury to the anterior
section of Wharton’s duct may result in leakage of
saliva into the surrounding soft tissues in the anterior
oral floor. When the patient eats, this may simulate
ranula.6
Treatment consists of locating the damaged duct
area after excising the overlying mucosa, isolating the
duct and milking the gland. A flow of saliva will locate
and demonstrate the extent of injury. In this case,
374
FIGURE 10. A, A moderately large retention cyst of Wharton’s duct
of 10 years duration, extending along the plica sublingualis with
obstructive symptoms. (Reprinted with permission.6) B, The cyst is
unroofed, and a wide lacrimal probe is placed into the lumen. The
duct is sutured to the adjacent mucosa.
sialodochoplasty consists of making a longitudinal in-
cision (1 to 1.5 cm) in the superior wall of the duct
posterior to the leakage and inserting a lacrimal probe
into its lumen, directed toward the gland. The incised
margins of the duct are spread laterally, and each side
is sutured to the adjacent mucosa with 2 gut sutures.
A single suture is then placed through the superior
wall of the duct at the proximal end of the longitudi-
nal incision to engage the overlying mucosa. Foods to
stimulate saliva and periodic duct dilation will result
in a new, well-functioning opening.
RETENTION CYSTS OF THE SUBLINGUAL GLAND
Retention cysts of the ducts of Rivini may involve
single or multiple duct openings so that the lesions
will range from miniscule to moderate in size (Fig 11).
Treatment consists of unroofing with or without pe-
ripheral sutures.
MUCOCELES AND RANULAS
Simple marsupialization in these cases will elimi-
nate the involved duct openings and allow normal
healing of the overlying mucosa. The acini that had
been serviced by these ducts will either atrophy or
have their secretions evacuated through the still-func-
tioning Bartholin’s duct. These cysts rarely, if ever,
recur.
TREATING RANULA FROM THE BODY OF THE
SUBLINGUAL GLAND
The mystery of why the majority of large ranulae,
which originate from the body of the sublingual
gland, develop without any history of trauma was
answered by the work of Harrison and Garrett.8 These
authors studied the effects of ligating the sublingual
duct in cats with the chorda tympani nerve intact. In
all cases, initial extravasation of mucus occurred for
the first 20 days, and approximately one half devel-
oped mucoceles thereafter. The authors suggested
that duct obstruction led to the extravasation of mu-
cus from ruptured acini rather than from duct leakage
and that the mucus then passed through the imper-
fect gland capsule into the tissue. This was confirmed
by Glen,9 a veterinarian, who performed sialograms
on dogs with ranulae and observed that the ducts
showed no evidence of leakage.
Obstruction could occur as a result of mucus plugs
and debris in Bartholin’s duct, which would result in
a more superficial ranula. For the more commonly
seen deep ranula, it would occur after obstruction of
aberrant (deviation from normal) ducts found in the
more posterior, deeper part of the gland. These ducts
open into the posterior section of the submandibular
duct (Fig 12).
The surgeon should be aware that on occasion,
trauma may be an initiating factor in ranula. In most
FIGURE 11. Retention cyst of a group of ducts of Rivini. (Reprinted
with permission.6)
HAROLD D. BAURMASH 375

REFINED MARSUPIALIZATION TECHNIQUE WITH

PACKING
The majority of atraumatically developing deep
ranulae are located on the medial surface of the sub-
lingual gland (Fig 13A). Whenever possible, a lacrimal
probe should be inserted into Wharton’s duct for its
protection and then the cystic area should be un-
roofed. After the mucus has been evacuated, the cav-
ity should be packed to its depth. Interrupted sutures

FIGURE 12. Submandibular gland sialogram shows sublingual

gland aberrant ducts entering the posterior portion of Wharton’s duct
(arrow).

cases, it is iatrogenic. The most common cause is after

sialolithotomy and relates to improper incisional de-
sign or excessive trauma to the gland while trying to
locate Wharton’s duct. Anatomically, Wharton’s duct
lies on the medial surface of the sublingual gland.
Therefore, the incision should be medial and parallel
to the plica sublingualis. An incision lateral to the
plica will disrupt and injure the penetrated sublingual
gland while the surgeon is attempting to locate and
isolate Wharton’s duct. Mucus extravasation may be
the result. In these cases, the ranula will be on the
lateral surface of the gland. Conversely, if the incision
is in the correct position, the dissection should be
aimed at the anterior portion of the duct, which is
more superiorly positioned in the oral floor. For these
cases, the direction of exploration should be inferior
and only slightly lateral. If excessive glandular disrup-
tion occurs, the ranula will be medial to the gland.
Mucoceles may develop up to 3 months after stone
removal.
Harrison and Garrett10 also noted that the one half
of cats that initially extravasated mucus but failed to
develop mucoceles showed a severe inflammatory
reaction. This reaction included macrophages, which
absorbed the mucus, and an extensive connective
tissue response that sealed the leakage, leading to
atrophy of the effected acini. This observation was
the rationale for modifying the standard marsupializa-
tion technique to decrease the recurrence rate by
adding gauze packing into the cavity after unroofing.
The pressure of the pack temporarily seals the leak,
and its continued presence evokes, in most cases,
severe enough inflammation to initiate sufficient fi-
FIGURE 13. A, A large ranula medial to the body of the sublingual
brosis to permanently seal the leak, leading to acini gland. B, The pack is in place after unroofing and the margins sutured
atrophy and healing. with resorbable sutures. Note the lacrimal probe in Wharton’s duct.
376 MUCOCELES AND RANULAS

are placed around its margins. The purpose of the

sutures is to provide better access for additional pack-
ing, if necessary, and also to maintain an opening to
facilitate the expulsion of the gauze packing from the
oral floor (Fig 13B). Keeping the packing in place for
at least 7 to 10 days is advised. If possible, allow for it
to begin natural exfoliation before removal. Antibiot-
ics are not necessary. Rapid healing follows pack
removal.
Packing of the deep ranula has been used in chil-
dren as well as elderly patients with significant suc-
cess.

Variations of the Deep Ranula

The superficial dissecting ranula5 is a rare occur-
rence, with a bilateral presentation, which is excep-
tionally large in size. Normally, the lingual frenum
appears to act as a restraining barrier, preventing the
ranula from expanding across the midline. This may
be overridden by excessive amounts of mucus leak-
age and more resistance inferiorly, resulting in exces-
sive superior pressure. Be aware that the origin is
always unilateral and the ranula arises from the deep
medial surface of the sublingual gland.
Although the cystic lesion is bilaterally enlarged,
the side of origin will appear a bit more prominent.
(Fig 14A). After placement of a tongue suture to
stabilize the surgical area, a horizontal mucosal inci-
sion is made across the midline. The incision is made
a safe distance from the openings of Wharton’s duct
and clearly shows the cyst lining. The exposed lining
is unroofed, and the gauze packing is firmly inserted
to the full depth of the site of origin (Fig 14B). The
mucosal margins are then sutured with interrupted
absorbable sutures. There is generally some postop-
erative swelling after which normal healing occurs.
Gossett et al11 described a classic superficial dissect-
ing ranula combined with a plunging ranula treated
successfully with gauze packing for 2 weeks.
The plunging ranula occurs when there is a suffi-
ciently large perforation of the mylohyoid muscle,
which allows fluid from the sublingual gland to enter
the submandibular space. In these cases, it is not
unusual to see a large external swelling with a subtle FIGURE 14. A, Superficial dissecting ranula in a 7-year-old boy with
HIV. Note the apparent accentuation toward the left side. B, The
intraoral mass in the oral floor. At times, the extraoral gauze packing contains radiopaque material that clearly shows the
swelling may not be exceptionally large (Fig 15A). For unilateral origin of the mucocele.
cases in which the diagnosis is in doubt, computed
tomography or magnetic resonance imaging will aid
in the diagnosis (Fig 15B). fects. One possible explanation is that the majority of
Nathan and Luchanski12 studied 150 cadavers and sublingual gland ranulae not associated with trauma
found such defects in 42%. In 17%, the cysts were develop on the medial surface of the gland, which is
bilateral. Most were located in the anterior two thirds opposite to that of the usual sites of mylohyoid de-
of the mylohyoid and laterally, closer to the mandible. fects.
Plunging ranulas are not as common as might be Removal of the sublingual gland is the recom-
suspected with the high incidence of mylohyoid de- mended primary treatment of the plunging ranula.
HAROLD D. BAURMASH
FIGURE 15. A, A moderate swelling in the submandibular and
submental area suggests a plunging ranula. B, Computed tomography
shows a cystic lesion in the area, confirming a plunging ranula.
Additional indications for surgical removal of the sub-
lingual gland include a recurrent ranula after a single
marsupialization with packing and hypertrophied
sublingual glands that interfere with prosthetic recon-
struction.
FIGURE 16. A, The gland was excised for a recurrent ranula. Note the placement of a lacrimal probe in Wharton’s duct preoperatively. B, Two
weeks postoperatively, healing has progressed and the lacrimal probe confirms the absence of ductal stenosis. Remnants of the incision line (arrow)
clearly depict its location, direction, and length.
377
Technique
The sublingual gland is always removed via an in-
traoral approach. Primary attention should be di-
rected toward avoiding injury to the lingual nerve or
Wharton’s duct that might result in perforation or
stenosis. A lacrimal probe should be inserted into the
submandibular duct before the incision and kept in
place for the entire procedure to make the duct
readily identifiable at all times (Fig 16A). A longitudi-
nal incision is made through the mucosa in a pos-
teroanterior direction midway between the plica sub-
lingualis and the lingual of the mandible from the
second molar to the cuspid area. This is anterior to
where the lingual nerve descends to enter the oral
floor.
Dissection begins on the lateral side of the anterior
two thirds of the gland and is carried down to the
surface of the mylohyoid muscle because there are no
vital structures in this plane. After the lateral and
anterior portion of the gland is freed, several retract-
ing sutures may be placed through its superior area to
facilitate the dissection of the medial surface of the
anterior two thirds of the gland and its careful sepa-
ration from the probe containing Wharton’s duct. A
moistened gauze pad or “peanut” in front of an ele-
vator provides safe blunt dissection. Bleeding will not
be a problem as long as the dissection remains lateral
to the duct because the sublingual artery is situated
medial and slightly inferior to it.
After the anterior two thirds of the gland have been
dissected and freed, the retraction sutures are used to
lift the gland superiorly and somewhat anteriorly.
Careful blunt dissection is continued on the medial
posterior portion of the gland until the lingual nerve
is identified and isolated as it crosses underneath the
submandibular duct. The lingual nerve is gently sep-
arated from the gland followed by the complete sep-
378
aration and removal of the gland from the oral floor.
After 1 week of healing, lacrimal probes may be used
to prevent ductal stenosis (Fig 16B).
References
1. Sicher H: Oral Anatomy (ed 2). Philadelphia, PA, Mosby,
1952, p 201
2. Crysdale WS, Mendelsohn JD, Conley S: Ranulas - mucocoeles
of the oral cavity: Experience in 26 children. Laryngoscope
98:296, 1988
3. Catone GA, Merrill RG, Henny FA: Sublingual gland mucus
escape phenomenon: Treatment by excision of sublingual
gland. J Oral Surg 27:774, 1969
4. Bridger AG, Carter P, Bridger GP: Plunging ranula: Literature
review and report of 3 cases. Aust N Z J Surg 59:945, 1989
MUCOCELES AND RANULAS
5. Baurmash HD: Marsupialization for treatment of oral ranula: A
second look at the procedure. J Oral Maxillofac Surg 50:1274,
1992
6. Baurmash HD: Treating oral ranula: Another case against blan-
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7. Mason DK, Chisholm DM: Salivary Glands in Health and Dis-
ease, (ed 1). Philadelphia, PA, Saunders, 1975, p 37
8. Harrison JD, Garrett JR: Mucocele formation in cats by glandu-
lar duct ligation. Arch Oral Biol 17:1403, 1972
9. Glen JB: Salivary cysts in the dog: Identification of sublingual
duct defects by sialography. Vet Rec 78:488,1966
10. Harrison JD, Garrett JR: Histologic effects of ductal ligation of
salivary glands of the cat. J Pathol 118:245, 1975
11. Gossett JD, Smith KS, Sullivan SM, et al: Sudden sublingual and
submandibular swelling. J Oral Maxillofac Surg 57:1353, 1999
12. Nathan H, Luchanski E: Sublingual gland herniation through
the mylohyoid muscle. J Oral Surg 59:21, 1985