Interactive Transcript
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So this is an example of a classic case
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that involves the floor of the mouth.
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So again, when we look at this
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area, the anatomy is so important.
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So let's take a look at our axial images.
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And again, there's our friend, the genioglossus
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muscle that extends from the genial
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tubercle posteriorly towards the tongue base.
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And what we see here are paired areas of low
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attenuation that represent fluid that are
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located lateral to the genioglossus muscle.
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When we look at the coronal images, here's our
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genioglossus muscles here, and here we can see these
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fluid collections that are just lateral to it.
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And if we continue looking laterally, we can see this
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muscle right here, which is the mylohyoid muscle.
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So what we're seeing here are bilateral fluid
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collections that are involved in the sublingual space.
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That are located lateral to the genioglossus
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muscle, and medial to the mylohyoid muscle.
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When we give contrast, we can see that
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there's no peripheral enhancement.
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So what this study indicates is
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characteristic of our bilateral ranulas.
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So what is a ranula?
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A ranula is a congenital
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obstruction of the sublingual gland.
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Ranulas can be unilateral, or in this
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case you can see that they're bilateral.
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Ranulas can be located and
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confined to the floor of the mouth.
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As is seen here, we see that all of the ranulas
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are above the level of the mylohyoid muscle.
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So in that case, if a ranula is in the
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floor of the mouth and confined to that,
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that's referred to as a simple ranula.
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However, occasionally ranulas can extend
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inferiorly below the mylohyoid muscle to
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involve this space that's located below.
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The mylohyoid muscle, and that is the submandibular space.
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If the ranulas extend inferiorly through
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the mylohyoid muscle, then believe it
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or not, it actually has three names.
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So that's a thing about head and neck—same
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piece of anatomy, and give it different names.
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So if the ranula extends below the mylohyoid
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muscle, they can be called a diving ranula.
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It can also be called a complex ranula,
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or if you will, if the ranula plunges
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through the mylohyoid muscle,
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it's called a plunging ranula.
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So the terms diving, complex, and plunging
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are the exact same disease entity.
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So in summary, this is a case of bilateral ranulas.
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In this case, it's above the mylohyoid
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muscle, so they're simple ranulas.
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But we also talked about the difference
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between a simple and complex ranula.
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