202 International Journal of Scientic Study | October 2014 | Vol 2 | Issue 7Management of Oral Mucocele: A Case ReportNamish Batra1, Renu Batra2, Dharmesh Vasavada3, Rashmi G S Phulari41Senior Lecturer, Department of Oral and Maxillofacial Surgery, Manubhai Patel Dental College and Hospital, Mujmahuda, Vadodara, Gujarat, India, 2Senior Lecturer, Department of Conservative Dentistry and Endodontics, Manubhai Patel Dental College and Hospital, Mujmahuda, Vadodara, Gujarat, India, 3Senior Lecturer, Department of Oral Pathology, Manubhai Patel Dental College,Vadodara, Gujarat, India, 4Reader, Department of Oral and Maxillofacial Surgery, Manubhai Patel Dental College and Hospital, Mujmahuda, Vadodara, Gujarat, IndiaCorresponding Author: Dr. Namish Batra, Manubhai Patel Dental College, Munjmahuda, Vadodara - 390 011, Gujarat, India. Phone: +91-9537508008. E-mail: drnamish_mds@yahoo.commucoceles are formed by dilation ofthe duct secondary to its obstruction caused by a sialolith. The majority ofretention cysts develop in the ducts ofthe major salivary glands.4,5Clinical CharacteristicsMucoceleisthecommonsalivaryglanddisorder,andit isthesecondcommonbenignsofttissuetumorinthe oral cavity. It is characterized by accumulation ofmucoid materialwithrounded,wellcircumscribedtransparent, bluish colored lesion ofvariable size. It is a soft, uctuant painless swelling with rapid onset that frequently resolves spontaneously. It is common in rst three decades oflife with equal gender prevalence.CASE REPORTA 36-year-old male patient reported with a chiefcomplaint ofsolitaire diffuse swelling in lower lip since 3 days. Patient alsogavehistoryof previousswelling2monthsinthe same region which resolved on its own. Medical and dental history was not contributory. Patient is habituated to lower lipbiting.Extraorallynogrossasymmetrywasdetected. Intraorallyasinglediffuseswellingof 1cm21cm2is seenwhichwasroundinshape,withasmoothsurface INTRODUCTIONMucoceleisacommonlesionof theoralmucosathat resultsfromanalterationof minorsalivaryglandsdue toamucousaccumulation.Mucoceleinvolvesheavily glycosylatedproteinsaccumulationcausinglimited swelling.1 Two different variants ofmucocele can appear: Extravasation and retention. Extravasation type is due to the leaking ofuid from the salivary gland ducts and acini tosurroundingsofttissues.Retentionmucoceleappears due to decrease or absence ofglandular secretion produced by blockage ofsalivary gland ducts.2 Clinically, there is no differencebetweenextravasationandretentiontypeofmucocele.EtiopathogenesisTrauma and obstruction ofthe gland are considered to be the most common pathologies.3 Extravasation mucoceles undergothreeevolutionaryphases.Intherstphase, mucous spills from the excretory duct into surrounding tissues where some leukocytes and histiocytes are found. Granulomas become visible during the resorption phase duetohistiocytes,macrophagesandmulti-nucleated giantcellsassociatedwithaforeignbodyreaction.In the nal phase, connective cells form a pseudo capsule withoutepitheliumaroundthemucosa.1Retention CaseReportAbstractMucocele is benign painless swelling of minor salivary gland, which most commonly involves lower lip and is characterized asdiffuseanductuant.Itischaracterizedbyaccumulationofmucinwithspherical,well-circumscribedtransparent,bluish colored lesion. Most of the time mococele is smaller than 1 cm extravasation cyst is mostly seen in association minor salivary glandwhereasretentioncystinassociationwithmajorsalivarygland.Manytreatmentmodalitieshavebeenmentionedin the literature, and surgical excision is advocated. The aim of this article is to emphasize on different treatment modalities and present a case report of complete excision of mucocele.Keywords: Extravesation, Mucocele, Retention, Salivary gland203 International Journal of Scientic Study | October 2014 | Vol 2 | Issue 7Batra, et al.: Extravesation Mucoceleand a bluish translucent hue (Figure 1). The swelling was soft in consistency, uctuant, non-tender, non-reducible, compressible,afebrileandnon-pulsatile,Adifferential diagnosis ofmucocele, lipoma, oral hemangioma, and oral lympangioma, was made. Since the swelling was small it was decided to surgically remove under local anesthesia. Using blunt dissection cystic cavity was removed intact along with excision ofaccessory salivary glands (Figure 2). Closure is done with 4-0 vicryl.DISCUSSIONThe appearance ofmucocele is pathognomonic, therefore, the knowledge concerning the lesion location, history oftrauma,infection,variationsinsize,bluecolorandalso theconsistencyhelpsinthediagnosisof suchlesions.6,7 The history and clinical ndings help in diagnosing ofa supercial mucocele. Radiographic evaluation is considered to be a diagnostic factor in the formation oforal ranulas to rule outsialoliths.Removalof theaccessorysalivaryglandshasbeen urgedasthetreatment.Marsupializationcansolelylead torecurrence,butlargelesionsarebesttreatedwith marsupialization.Laser,cryosurgery,andelectrocautery havealsobeenusedfortreatmentof theconventional mucoceles.8,9 Intralesional corticosteroid injection are also considered in the management oforal mucocele, but some studies suggested that the initial cryosurgery or intralesional corticosteroid injection relapse is more often.10 Removal ofsurrounding glandular acini, excision or dissection oflesion down to the muscle layer and avoiding damage to adjacent gland and duct are some strategies to reduce recurrence.11 Histopathologicalreportpresenteditasextravasation mucocele and accessary minor salivary glands (Figure 3). Microscopically,mucocelesappearasgranulationtissue, neutrophils, and histiocytes.CONCLUSIONMucocele is the most common benign lesion ofthe oral cavity. Majority ofthese cases can be diagnosed clinically. Managementof mucoceleisdonesurgicallybyexcision ormarsuplizationdependingonthesizeof thelesion. Recurrence is rare ifmanaged accurately. REFERENCES1.BagnSebastinJV,SilvestreDonatFJ,PearrochaDiagoM,Milin MasanetMA.Clinico-pathologicalstudyoforalmucoceles.Av Odontoestomatol 1990;6:389-91, 394-5.2.Baurmash H. The etiology of supercial oral mucoceles. J Oral Maxillofac Surg 2002;60:237-8.3.YamasobaT,TayamaN,SyojiM,FukutaM.Clinicostatisticalstudyof lower lip mucoceles. Head Neck 1990;12:316-20.4.BaurmashHD.Mucocelesandranulas.JOralMaxillofacSurg 2003;61:369-78.5.Ata-Ali J, Carrillo C, Bonet C, Balaguer J, Pearrocha M, Pearrocha M. Oral mucocele: Review of the literature. J Clin Exp Dent 2010;2:18-21.Figure 1: Clinical presentation of mucoceleFigure 2: Grossing image of intact mucocele with accessory salivary glandsFigure 3: Photomicrograph of mucoceleBatra, et al.: Extravesation Mucocele204 International Journal of Scientic Study | October 2014 | Vol 2 | Issue 76.Bentley JM, Barankin B, Guenther LC. A review of common pediatric lip lesions: Herpes simplex/recurrent herpes labialis, impetigo, mucoceles, and hemangiomas. Clin Pediatr (Phila) 2003;42:475-82.7.GuimaresMS,HeblingJ,FilhoVA,SantosLL,VitaTM,CostaCA. Extravasation mucocele involving the ventral surface of the tongue (glands of Blandin-Nuhn). Int J Paediatr Dent 2006;16:435-9.8.Anastassov GE, Haiavy J, Solodnik P, Lee H, Lumerman H. Submandibular glandmucocele:diagnosisandmanagement.OralSurgOralMedOral Pathol Oral Radiol Endod 2000;89:159-63.9.Jenesen JL. Supercial mucoceles of the oral mucosa. Am J Dermatopathol 1990;12:88-92.10.Yage-Garca J, Espaa-Tost AJ, Berini-Ayts L, Gay-Escoda C. Treatment of oral mucocele-scalpel versus CO2 laser. Med Oral Patol Oral Cir Bucal 2009;14:e469-74.11.GuptaB,AnegundiR,SudhaP,GuptaM.Mucocele:Twocasereports. J Oral Health Community Dent 2007;1:56-8.How to cite this article: Batra N, Batra R, Vasavada D, Phulari RGS. Management of oral mucocele: A Case Report. Int J Sci Stud 2014;2(7):202-204.Source of Support: Nil, Conict of Interest: None declared.