Primary treatment of ranula with intracystic injection of OK-432.
OBJECTIVE
Although surgery is the first choice of therapy for ranula, it was made a hypothesis that ranula can be primarily treated with sclerotherapy from prior evidence. This study examined the effectiveness of intracystic injection of OK-432 for treatment of ranula.


METHODS
This prospective clinical study comprised a total of 26 patients with ranula (19 intraoral type; seven plunging type) treated with OK-432 sclerotherapy. Aspirated mucus of ranula was replaced with an equal volume of OK-432 solution of 0.01 mg/mL. The size of ranula was compared before and after sclerotherapy.


RESULTS
Twenty of 26 patients (77%) showed a complete response after sclerotherapy: higher in plunging ranula (86%) than in intraoral ranula (74%). Rupture of ranula developed in seven of 19 patients (37%) with intraoral ranula within a few days after injection. The early rupture occurred more frequently in patients having a less-than-marked response and seemed to cause an increase in the total number of OK-432 injections: seven ruptured cases versus 12 nonruptured cases (mean 3.6 versus 1.5, P<.001). Recurrence occurred in two patients during a median follow-up period of 12 months (range, 9-22 mo) after the last injection. There were no major side effects, scarring, or increased morbidity to surgery of the OK-432-injected lesions.


CONCLUSIONS
The intracystic injection of OK-432 is highly effective as a primary treatment modality of ranula.
Department of Otolaryngology-Head and Neck Surgery, Cancer Research Institute, Chungnam National University College of Medicine, Daejeon, Republic of Korea. rohjl@nu.ac.kr
Jong-Lyel
JL
Roh
D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D010844:Picibanil / Q000008:administration & dosage*; D011446:Prospective Studies; D011900:Ranula / Q000188:drug therapy* / Q000628:therapy; D012008:Recurrence; D012597:Sclerosing Solutions / Q000008:administration & dosage*; D013396:Suction; D016896:Treatment Outcome
D012597:Sclerosing Solutions; D010844:Picibanil