title: Plunging ranula: congenital or acquired?
abstract: OBJECTIVE
  To review our clinical experience with plunging ranula and examine the evidence in support of our impression that plunging ranula has a genetic basis.
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  Secondary otolaryngology service.
  
  
  METHODS
  Review of the medical records of a clinical series of 80 consecutive plunging ranulas in 77 patients was conducted, with recording of clinical and radiological findings, surgical treatment, and outcome. A literature review using MEDLINE and OLD MEDLINE was performed.
  
  
  RESULTS
  The majority of plunging ranulas had no intraoral component on clinical examination, although evidence of mucus extravasation from the sublingual gland could be found both radiologically and histologically in all cases. There were four patients with bilateral plunging ranula and one instance of siblings with unilateral plunging ranula. Maoris and Polynesians comprised more than 82 percent of our cases; this was a significant overrepresentation of these ethnic groups (P < 0.0001). A very strong predominance of cases of Chinese origin was also evident in the literature.
  
  
  CONCLUSIONS
  The clinical findings and the supporting data from the literature, when viewed in light of information relating to the known anatomical anomaly of a dehiscence in the mylohyoid muscle and ectopic sublingual gland lying below the plane of the mylohyoid, appear to support the case for a genetic basis for this unusual clinical entity.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Manukau DHB, Manukau City, New Zealand. RPMorton@middlemore.co.nz
authors.forename: Randall P
authors.initials: RP
authors.lastname: Morton
authors.forename: Zahoor
authors.initials: Z
authors.lastname: Ahmad
authors.forename: Prabha
authors.initials: P
authors.lastname: Jain
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck; D011446:Prospective Studies; D011900:Ranula / Q000151:congenital / Q000209:etiology / Q000235:genetics*; D055815:Young Adult