Definitions

retromolar pad

Mucocele

An oral mucocele, also referred to as mucus extravasation phenomenon, is a swelling of connective tissue consisting of collected mucin from a ruptured salivary gland duct, which is usually caused by local trauma. The mucocele is a bluish translucent color, and is more commonly found in children and young adults.

It can be considered a polyp or a cyst.

Locations

The most common location to find a mucocele is the surface of the lower lip. It can also be found on the inner side of the cheek (known as the buccal mucosa), on the anterior ventral tongue, and the floor of the mouth. When found on the floor of the mouth, the mucocele is referred to as a ranula. They are rarely found on the upper lip. As their name suggests they are basically mucus lined cysts and they can also occur in the Paranasal sinuses most commonly the frontal sinuses, the frontoethomidal region and also in the maxillary sinus. Sphenoid sinus involvement is extremely rare. When the lumen of the vermiform appendix gets blocked due to any factor, again a mucocele can form.

Characteristics

The size of oral mucoceles vary from 1 mm to several centimeters. On palpation, mucoceles may appear fluctuant but can also be firm. Their duration lasts from days to years, and may have recurrent swelling with occasional rupturing of its contents.

Variations

A variant of a mucocele is found on the palate, retromolar pad, and posterior buccal mucosa. Known as a "superficial mucocele", this type presents as single or multiple vesicles and bursts into an ulcer. Despite healing after a few days, superficial mucoceles recur often in the same location.

Histology

Microscopically, mucoceles appears as granulation tissue surrounding mucin. Since inflammation occurs concurrently, neutrophils and foamy histiocytes usually are present.

Treatment

Some mucoceles spontaneously resolve on their own after a short time. Others are chronic and require surgical removal. Recurrence may occur, and thus the adjacent salivary gland is excised as a preventive measure.

Several types of procedures are available for the surgical removal of mucoceles. These include laser and minimally-invasive techniques which means recovery times are reduced drastically.

References

  • Kahn, Michael A. Basic Oral and Maxillofacial Pathology. Volume 1. 2001.

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