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Mucocele
INTRODUCTION
- Mucocele is defined as a mucus filled cyst that can appear in the oral cavity, appendix, gall bladder, paranasal sinuses or lacrimal sac
- The term mucocele is derived from a latin word, mucus and cocele means cavity
- Mucocele is seventeenth most common salivary gland lesions seen in the oral cavity
- This is the result of accumulation of mucus due to the alteration in the minor salivary gland which causes limited swelling
- The mucocele is a common lesion of the oral mucosa involving salivary glands and their ducts.
- Cyst lack epithelial lining they are not true cyst.
- These lesions are devoid of epithelial lining and are also termed as,
- Superficial mucocele
- Classical mucocele.
- The mucocele has a bluish translucent color, and is more commonly found in children and young adults
NOTE
Ranulas are mucoceles that are of major salivary gland origin and occur on the floor of the mouth.
Have two types: oral ranulas and cervical/plunging ranulas. While the oral ranulas form because of leakage and accumulation of secretions of major salivary gland above the mylohyoid muscles, cervical/plunging ranulas result from the collection of mucus along the fascial planes of the neck.
TYPES
| Extravasation type | due to the leaking of fluid from the salivary gland ducts and acini to surrounding soft tissues |
| Retention type | obstruction of salivary gland duct |
SITES
- Lower labial mucosa > floor of the mouth > ventral tongue > buccal mucosa
- Superficial mucoceles are most common at the soft palate, retromolar pad and buccal mucosa
- Very rare at the upper labial mucosa as it is difficult to traumatize that site; neoplastic minor salivary gland lesions should be considered
ETIOLOGY
- Obstruction of the duct of a minor salivary gland
- Trauma
It can cause due to- Traumatic severance of a salivary duct
- Produced by biting the lips or cheek
- Pinching the lip by extraction forceps and the like, leading to spillage of mucin into the sorrounding tissues
PATHOPHYSIOLOGY
OR
Another way that leads to the development of these lesions due to obstruction of
the excretory duct of the salivary glands secondary to sialolith, periductal
scarring or fibrosis, tumor.
CLINICAL FEATURES
- Mucoceles are commonly observed in all decades of life
- It appears as a raised , domeshaped vesicles,ranging in size from 1 to 2 mm to several centimetres.
- Moveable and painless
- Soft, round
- Pearly or semi-clear surface or bluish in color
- The mucoceles may lie deep in the tissues or exceptionally superficial
HISTOLOGIC FEATURES
- Mucoceles appears as granulation tissue surrounding mucin.
- Since inflammation occurs concurrently, neutrophils and foamy histiocytes usually are present.
- On a CT scan, a mucocele is fairly homogenous, with an attenuation of about 10-18 Hounsfield units.
DIAGNOSIS
- Biopsy
- Ultrasound
- Computerized tomography (CT) scan
TREATMENT
- Surgical Excision
- Aspiration: It is not considered as an appropriate therapy for mucoceles as the recurrence rate is quite higher. Instead, it is preferred to eliminate other entities before surgical excision.
- Marsupialization
- Laser Ablation, Cryosurgery, and Electrocautery: They are mostly performed for the superficial mucoceles
