Скачать или смотреть MUCOCELE

Definition
• A mucocele is a mucus-filled cystic lesion of the minor salivary glands.
• Most commonly found on the lower lip due to trauma to minor salivary ducts.

Etiology & Pathogenesis

Causes:
• Trauma or rupture of salivary duct (biting lip, bruxism, sharp teeth)
• Obstruction of salivary duct (rare)

Types:
1. Extravasation mucocele (common):
• Due to rupture of the duct
• Mucus escapes into surrounding tissue → forms pseudocyst (no epithelial lining)
2. Retention mucocele (less common):
• Due to obstruction of duct
• True cyst (lined by epithelium)

Common Sites
Site
Frequency
Lower lip
Most common (70-80%)
Buccal mucosa
Less common
Floor of mouth
Called ranula
Ventral tongue
Blandin–Nuhn mucocele

Clinical Features
• Age: Common in children and young adults
• Appearance:
• Dome-shaped, soft, fluctuant swelling
• Bluish or translucent hue
• Size: Few mm to 1–2 cm
• Consistency: Soft/fluctuant
• Pain: Usually painless unless secondarily infected
• Behavior: May rupture and recur

Differential Diagnosis
• Fibroma
• Lipoma
• Hemangioma
• Lymphangioma
• Salivary gland neoplasm
• Oral cysts (e.g., epidermoid cyst)

Diagnosis
• Clinical examination (most cases)
• Transillumination test (shows clear fluid inside)
• Ultrasound (cystic lesion)
• Histopathology (confirms type: extravasation vs retention)

Histopathology

Extravasation Mucocele:
• No epithelial lining
• Mucous pooled in connective tissue
• Surrounding granulation tissue
• Foamy macrophages

Retention Mucocele:
• True cyst with epithelial lining (cuboidal/columnar)
• Dilated duct

Management
1. Surgical Excision:
• Complete removal with surrounding minor salivary glands
• Prevents recurrence
2. Marsupialization:
• Especially for large lesions (e.g., ranula)
3. Cryotherapy or laser excision:
• For small superficial mucoceles
4. Avoid trauma:
• Remove source of trauma (sharp tooth, habits)
Prognosis
• Excellent with complete excision
• Recurrence possible if lesion is incompletely excised or underlying gland not removed

Prevention
• Avoid chronic lip biting or trauma
• Habit counseling in children
#anatomy #biology #ear #ent #nose #nosebleed #otolaryngology #science #throathealth #tonsils