Mucocele [Salivary Gland]

Causes and risk factors

Mucocele arises from minor salivary glands. Mucocele usually occurs due to rupture or blockage of salivary gland. There is accumulation of mucus in the minor salivary glands. There are two types of mucocele – mucus extravasation cyst and retention cyst. Mucus extravasation cyst is a common type. It occurs due to broken salivary gland duct and spilling of the contents into surrounding soft tissue around the gland. The cyst has no epithelial lining. It is characterized by mucous pool surrounded by granulation tissue. Retention cyst occurs due to absence or decrease in salivary gland secretions due to the blockage. It has epithelial lining. Other 3 varieties variants include superficial mucocele – which occurs directly under the mucosa; classic mucoclelemucocele seen in upper submucosa and deep mucocele located in the lower cornium. 

Clinical presentation

Mucocele occurs on lower lip, cheek, buccal  mucosa or even the ventral surface of tongue. Mucocele occurring in floor of the mouth is called ranula. It is bluish and soft. It is a solitary, well well-defined, dome dome-shaped swelling. It has a smooth surface. It is soft, non-tender, fluctuant, compressible, non-reducible, and non-pulsatile. It often bursts on touch. It has a tendency to recur. 

Investigation

Medical history by the patient and clinical examination by the doctor helps in diagnosis. Imaging studies such as CT scan, USG of the affected cheek may be useful for further evaluation. Sialogram may be performed. FNAC may be done.

Treatment 

Treatment involves steroid injections to reduce the swelling. Surgical excision of the mucocele is required. Incision and drainage will also help in managing the mucocele. Marsupialization may be performed. Removal of the salivary gland may be required.

Other Modes of treatment

The other modes of treatment can also be effective in treating mucoelemucocele. Homoeopathy is a science which deals with individualization and considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly, the Ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating mucoelemucocele.

Facts and figures 

Mucocele are 15th most common oral mucosal lesions. They occur 2.4 per 1000 people.