She first recognized her left oral floor swelling 15 months before she came to me. 10 months before, she had incision operation at her neiboring hospital. She had recurrence soon. So, she serched another treatment by internet. She found a dentist who treat ranula by OK-432. She had 3 injections of OK-432. Her ranula raptured within several days in all treatments. But, after 3 injections, her ranula became invisible for 2 months. But, 2 months after, her left submandibular swelling occured. So, she mailed me for consltaion of her treatment. I asked her to have MRI examination and send it to me. MRI showed that her ranula was combined type. She is living in very far place from my clinic, but she came to me for treatment.
These are her MRI. White area in MRI is ranula. The main pooling of fluid was submandibular space and a little pooling was seen at the oral floor. So, her ranula was thought to be a combined type. The right photo shows that saliva flows from sublingual gland to submandibular space.
This is her course after treatment. At the next day, her left
submandibular swelling was markedly swollen. This means very good
response. After 2
her ranua began to shrink. 5 weeks after OK-432 injection, her ranula
This is her course about oral ranula. At the next day, her left oral ranula was markedly swollen. This means very good response. and oral floor and plunging ranula were conncting each other.
Till 6 months after treatment, there was no recurrence.
Important point for this patient
1, She had an incision surgery for oral ranula but recurred soon.
2. She had three OK-432 injectios for oral ranula but raptured within several days.
3. After OK-432 injection for oral ranula, her ranula turned to be combined type mainly plunging.
1, Removal or marspialization
of ranula does not promise cure. Ranula is a leakage of saliva,
so if the leakage did not stop, it will recurr despite complete
removal was performed.
About 2. For good result of OK432 therapy, please do not have surgery. Weak mucous membrane after surgery may increase probabilty of rapture after OK-432 injection.
About 3. It is sometimes experienced that oral ranula
turned to be plunging ranula after surgery. Plunging ranula 1,
10, 14, 15, 17, 26, 29 and combined ranula 3, 5of
this home page were also
so. After operation, the mucosa of oral floor became hard (scar
formation) or the route of saliva flow was changed . So, leaked saliva
cannnot go upward, then saliva goes
to downward. Regrettably, still now, it is written in some medical
textbooks that complete removal is necessary for prevention of
recurrence. The strategy of ranula treatment is to stop leakage
from sublingual gland. Last year, I examined my cases. 21 % of plunging
or combined ranula was occured after surgery of oral ranula. I have
experienced more than 200 OK-432 injections for ranula. But, I have
never experienced such a case after OK-432 therapy. I think this may
from the first incision.