0:00

So this is an example of a classic case

0:03

that involves the floor of the mouth.

0:05

So again, when we look at this

0:06

area, the anatomy is so important.

0:09

So let's take a look at our axial images.

0:11

And again, there's our friend, the genioglossus

0:12

muscle that extends from the genial

0:14

tubercle posteriorly towards the tongue base.

0:17

And what we see here are paired areas of low

0:20

attenuation that represent fluid that are

0:23

located lateral to the genioglossus muscle.

0:26

When we look at the coronal images, here's our

0:28

genioglossus muscles here, and here we can see these

0:31

fluid collections that are just lateral to it.

0:35

And if we continue looking laterally, we can see this

0:37

muscle right here, which is the mylohyoid muscle.

0:41

So what we're seeing here are bilateral fluid

0:44

collections that are involved in the sublingual space.

0:47

That are located lateral to the genioglossus

0:50

muscle, and medial to the mylohyoid muscle.

0:52

When we give contrast, we can see that

0:54

there's no peripheral enhancement.

0:56

So what this study indicates is

0:59

characteristic of our bilateral ranulas.

1:02

So what is a ranula?

1:04

A ranula is a congenital

1:05

obstruction of the sublingual gland.

1:09

Ranulas can be unilateral, or in this

1:11

case you can see that they're bilateral.

1:14

Ranulas can be located and

1:16

confined to the floor of the mouth.

1:18

As is seen here, we see that all of the ranulas

1:21

are above the level of the mylohyoid muscle.

1:25

So in that case, if a ranula is in the

1:27

floor of the mouth and confined to that,

1:29

that's referred to as a simple ranula.

1:33

However, occasionally ranulas can extend

1:35

inferiorly below the mylohyoid muscle to

1:39

involve this space that's located below.

1:43

The mylohyoid muscle, and that is the submandibular space.

1:47

If the ranulas extend inferiorly through

1:50

the mylohyoid muscle, then believe it

1:52

or not, it actually has three names.

1:55

So that's a thing about head and neck—same

1:57

piece of anatomy, and give it different names.

1:59

So if the ranula extends below the mylohyoid

2:02

muscle, they can be called a diving ranula.

2:05

It can also be called a complex ranula,

2:09

or if you will, if the ranula plunges

2:12

through the mylohyoid muscle,

2:14

it's called a plunging ranula.

2:16

So the terms diving, complex, and plunging

2:19

are the exact same disease entity.

2:23

So in summary, this is a case of bilateral ranulas.

2:27

In this case, it's above the mylohyoid

2:29

muscle, so they're simple ranulas.

2:31

But we also talked about the difference

2:33

between a simple and complex ranula.