Plunging ranula (27)

The first sucessful case from foreign country

This patient was aware of his right submadibuler swelling from several months ago. He consulted doctors in two countries. In both countries, he was recommeded to have surgery. He found my web site and sent me a cousultation mail. At first, I asked him to send MRI to me. After examining MRI, I replyed that you must be plunging ranula and very good indication for OK-432 therapy. One day morning,  I got  a mail from him "If I come to you the day after tomorrow, can you treat me ?". And,  in the afternoon, I got another mail "I could get tomorrow's ticket. I will go tomorrow."

This is his MRI. White lesion means fluid collection.  The irregular shape is typical to ranula.

The 1st treatment.
I puctured the part with the strongest swelling of his right jaw and injected 1 KE of OK-432 susupended 2 ml of saline. 
On the next day, his swelling did not become strong and did not become hard either. Also, no fever and no pain. This means no response. We waited 3 days. But, there was still no response.
So, I made an additional OK-432 0.5 KE injection to him. On the next day, his right jaw was markedly swollen. This means good response. After that, he returned to his country. One week after, his swelling became hard.
After 2 weeks, the swelling became smaller and smaller and the swelling at 6 weeks after treatment was totally gone.

The subsequent progress.
8 weeks after treatment, I received the photographs that he had small swelling again. 10 weeks after, the swelling became obvious. Of course, additional tratment was needed. But, I hesitated to tell him to come because he was living in foreign country. I wrote him that you shoud wait more. Surplizingly, he came to me again at 11 weeks after the first treatment.

The 2nd treatment
I injected 1.5 KE of OK-432 susupended with 4 ml of saline.  This time, strong reactive swelling was obseved on the next day. Pain and fever up were also observed. This means very good response. Two days after, he retured to his country. One week after, his swelling became hard and the size became already smaller. This is typical course that this medical treatment is effective. 2 weeks after, his swelling became more smaller and 4 weeks after, his swelling became invisible. 6 weeks after, he could not touch any induration at his right jaw.

The subsequent progress.
After the second treatment, no recurrence was observed for 6 months.

I appreciate him for coming not only one time and pay tribute to his  activity.

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