Combined Surgery with Low-Dose Radiation Treatment for an Extensive Plunging Ranula of Neck-A Case Report
許博智(Po-Chih Hsu)；張立平(Li-Ping Chang)；許修銨(Hsiu-An Hsu)；施嘉霖(Jia-Lin Shih)；李曉屏(Shiao-Pieng Lee)；陳元武(Yuan-Wu Chen)；夏毅然(Yi-Jan Hsia)
頸部蝦蟆腫 ； 放射線治療 ； Plunging ranula ； radiation therapy
|Volume or Term/Year and Month of Publication||
19卷4期（2008 / 12 / 01）
276 - 282
蝦蟆腫(Ranula)主要是因爲舌下腺之黏液漏出而形成之囊腫。它是一種假性囊腫，通常以兩種型式來表現：一是口底的蝦蟆腫，另一個是臨床上較少見的頸部蝦蟆腫(Plunging ranula)。頸部蝦蟆腫是因爲舌下腺所分泌之唾液溢漏越過了下頷舌骨肌(Mylohyoid muscle)蓄積到頸部閒隙所形成。本報告提出一罕見頸部蝦蟆腫病例，患者爲一位五十歲男性，來院主訴爲左側頸部腫脹，思者曾經有口腔化學藥物灼傷的病史，導致張口不全。經核磁共振檢查後，懷疑是頸部蝦蟆腫，於是安排患者住院接受手術。手術時，因爲口底嚴重纖維化與法由口內摘除口內的舌下腺及殘餘囊腫，於是在術後一星期傷口穩定後，安排進一步的放射治療，治療追蹤一年後與任何復發症狀。
Most of ranulas are developed as extravasation of mucous from sublingual glands. They are classified as a kind of pseudocysts. These pseudocysts are subclassified into two types: oral ranula and plunging ranula. Plunging ranulas are mucous retention cysts from the sublingual glands that cross the mylohyoid muscle and extend into the facial space of the neck. A 50 years old man, who suffered mouth-opening limitation due to chemical burn injury in oral cavity before, came to our hospital because of swelling of his left neck for a while. After MRI examination, plunging ranula was suspected. He, therefore, was admitted for further treatment. During surgery, because of severe scar fibrosis at the mouth of floor, it is difficult to remove oral sublingual gland and residual cyst via oral cavity. We arranged low-dose radiation therapy one week after surgery finished. There were no recurrent signs or symptoms during OPD follow-up in the past one year.