What Is a Ranula?

Medically Reviewed by Jabeen Begum, MD on November 11, 2021
3 min read

A ranula is a blue-tinted or clear cyst in your mouth caused by a blockage in the salivary gland. The growth can vary in size, depending on the severity of the condition. Some of these cysts remain small in size. Others grow large and can create problems. When a ranula growing at a fast pace ruptures, it's called a plunging ranula. 

Although everyone can have ranulas in their mouth, the Maori people of New Zealand are a population at high for this condition. You're likely to get ranulas in your mouth during your 20s or 30s. 

Sometimes, there's no known cause of the ranula formation. The swelling in the mouth could be a random occurrence. In other cases, an injury or trauma to the mouth can cause a ranula to develop. 

If there's an injury to the duct carrying saliva to the mouth from the salivary gland, a blockage could occur. Saliva accumulates in the salivary gland and forms a cyst since it cannot drain properly. This creates a ranula. 

Similarly, if you get hit in the face or bite your cheek too hard, a ranula could form. 

People with a plunging ranula can often detect their own symptoms. In some cases, doctors or family members may discover these symptoms. 

The most common sign of a ranula is a painless swelling under the chin or the tongue that is two to three inches in diameter. It's pretty easy to identify. Over time, the fluid-filled cyst begins to hurt. Its contents may empty into the mouth after some time. 

But the cyst fills up again in a few days, and the process continues. Some additional plunging ranula symptoms include difficulty in speaking and swallowing.

If a ranula is small and has not grown in the past few weeks, there may not be a need to go to the doctor. But if the ranula is increasing in size or has become painful, you'll need medical attention. 

A large ranula will also interfere with breathing, speech, swallowing, and eating. 

In many cases, doctors can diagnose the condition by looking at the cyst. Sometimes, they may order some imaging tests to confirm it's a ranula and not another, more concerning cyst. Some imaging tests for ranula diagnosis are CT scans, MRI, and ultrasounds

When a ranula starts interfering with your regular activities, your doctor may recommend making an incision to drain its fluid. It will reduce swelling, but the fluid may return.

If you have a large ranula, your doctor may recommend surgery. A surgeon will remove the cyst from your mouth along with the sublingual gland that's causing the problem. If they only remove the cyst and leave the gland behind, a new cyst could form later. 

Another plunging ranula treatment is marsupialization. In this method, the doctor cuts an incision or slit in the cyst. The edges are then sutured as the fluid drains from the cyst. 

Speak to your doctor about your symptoms, and they'll find the best treatment option according to your particular condition. 

If you get a submandibular gland removal surgery, the procedure to remove the gland and the ranula, your body will take a week or two to heal. During this time, the incision will heal, and the stitches will dissolve. 

If your doctor used glue to close the incision, it would also peel off itself in a few weeks of surgery. During the ranula surgery recovery time, you should:

  • Rest as much as possible. In four to five days after the surgery, put two or three pillows under your head to position it properly. 
  • Avoid strenuous activities, like riding a bike or weight lifting. You should also avoid working out for a week or longer, as instructed by your doctor. 
  • Don't lift anything that strains you in a week following the surgery. For instance, you should not pick grocery bags or a heavy backpack. 
  • Ask your doctor when it's the right time for you to drive again. 
  • Don't shave the skin on the top of the incision for the first week or two until your doctor gives you the go-ahead. You can shave the rest of your face and neck.