He had surgery (excision in the neck) before,
but his ranula recurred later.
This is his X-ray CT. The area which encircled by yellow line is ranula. It is suggested that saliva leakage from left sublingual gland might make his ranula.
Left is his cyst fluid. Right is smear of cyst fluid. These are typical for ranula.
The first treatment.
I punctured his submandibular skin and aspirated 20 ml of viscous cyst fluid. Then injected OK-432 (10 ml of OK-432 solution, concentration was 0.1 KE/ml, total OK-432 dose was 1 KE).
On the next day after treatment, his submandibular skin was injected and markedly swollen. But, there was no airway stenosis. 1 week after, his reactive swelling was not so hard. This means inflamation caused by OK-432 in this treatment was not enough. Regrettably, the effect of the first treatment was not enough.
The second treatment.
8 weeks after the first treatment, the second treatment was done. This time, 2 KE of OK-432 was injected. Reactive swelling on the next day was enough and the swelling on 1 week after was hard. These means good responce. Cyst was disappeared without scar formation 6 weeks after treatment. There was no recurrence one year after treatment.
This therapy is easy and safe when the cyst is big like this case.
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