The following patient came from other county. He expected to be treated without surgery. His diagnosis in his country was ranula. The X ray CT was taken in his country and MRI was taken in Japan.
Actually, I was surprised because his pharyngeal space was deformed. His pharyngeal space was not synmmetrical, left pharyngeal space was compressed.
His axis of cervical vertebra was a little bit roatated. I was expecting his deformity would be from vertebra roatation.
This is the puncture procedure of the patient. I puncture his
cyst with 18 gauge needle. 15 ml of serous fluid with many debris
was aspirated , then I could not aspirate more. It is thoght that
only liquid content of dermoid cyst was aspirated. There were
also some hairs in his aspirated material. And many denatured
epithelia in it.
I deeply regretted that I could
not have true diagnosis before he came to Japan.
He had operation from neck in his country. He kindly sent me phtographs of his operation. His cyst was typical dermoid cyst.
The following two cases were who also came to me from very distant place with expecting to be treated without surgery.
Just above pictre is a series of MRI from madibulum to chin
in 15 years old patient.
About 7 years old girl
patient, I answered the followings to her mother's e-mai. She
is not ranula. The shape of her cyst was too round. This round
shaped cyst must be dermoid cyst. But, her mother could not give
up to be trated without surgery.
About 15 years
old patient, I was thinking the probability to be ranula would
be 50 %. Because the shape of cyst was irregular in some parts.
Cyst fluid was serous with white debris in both patient.
There were many denatured epithelis in bpth aspirated fluid.
Later, I got e-mails those both cases were ranla.
In 7 years old case, the cyst was excised from her neck. And,
in 15 years old case, the cyst was successfully removed from her
mouth.
The following patient was treated as ranula 3 years ago. He had right submandibular swelling from boyhood. He was diagnodes as ranula in a hospital where he lived near by. At first, he had OK-432therapy. But, the doctor could not aspirate cyst fluid, then only injection was performed. And, OK-432 therapy was no effect. Then, he had surgery, excision of submandibular gland and sublingual gland. This surgery was almost no effect.
He sent me e-mail hoping to have OK-432 therapy. At first,
I asked him to send photos and CTs by e-mail. These are photo
and CTs he sent me. The shape his cyst was almost round and the
shape of pharyngeal cavity was obviously deformed, This is the
same as the first case of this page. I answered him that you are
not ranula, must be dermoid cyst.
1 month after,
I got an e-mail from him. He got surgery from his neck, the diagnosis
was dermoid cyst. In this case, lucky the diagnosis of dermoid
cyst was could be done before comming to my clinic.
The following case was sent by other physician,
Abou this case, only point is knowing dermoid cyst or not.
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