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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 27:1090-1095, May 2006
© 2006 American Society of Neuroradiology

HEAD AND NECK

OK-432 Sclerotherapy of Plunging Ranula in 21 Patients: It Can Be a Substitute for Surgery

M.H. Rho^a, D.W. Kim^a, J.S. Kwon^a, S.W. Lee^a, Y.S. Sung^a, Y.K. Song^a, M.G. Kim^b and S.G. Kim^b

^a Department of Radiology, Masan Samsung Hospital, Sungkunkwan University School of Medicine, Masan, Korea
^b Department of Otorhinolaryngology-Head and Neck Surgery, Masan Samsung Hospital, Sungkunkwan University School of Medicine, Masan, Korea

Address correspondence to Myung Ho Rho, Department of Radiology, Masan Samsung Hospital, Sungkunkwan University School of Medicine, 50 Hapung2-dong, Masan, Gyeongsangnam-do, 630-522, Republic of Korea

BACKGROUND AND PURPOSE: Although first-choice therapy for the ranula is surgery, this choice presents technical difficulties and frequent recurrences because of insufficient surgery. We evaluated the efficacy of OK-432 sclerosis of the plunging ranula as a substitute for surgery.

METHODS: Twenty-one patients with plunging ranula were treated with intralesional injection of OK-432. The liquid content of the ranula was aspirated as much as possible, after which OK-432 solution was injected in the same volumes as that drawn out. Patients were followed on sonography or CT.

RESULTS: Seven (33.3%) patients with plunging ranulas showed total shrinkage and resolution, and 4 (19%) patients showed near-total shrinkage (more than 90% of the volume). Four (19%) patients revealed marked shrinkage (more than 70% of the volume), and 3 (14.3%) patients showed partial shrinkage (less than 70% of the volume). Three (14.3%) patients showed recurrence after total shrinkage 1 month after injection. The overall recurrence rate after each injection was 47% (16 of 34 injections in 21 patients), but the recurrence rate after the last sclerotherapy was only 14%. There were no serious side effects except for fever lasting 2–3 days (12 patients) and swelling (10 patients) for 3–5 days. Mild odynophagia for 1–2 days was also noted in 7 patients, and there was 1 severe case of odynophagia.

CONCLUSION: OK-432 sclerotherapy of plunging ranula is a safe and potentially curative procedure that may be used as a primary treatment for plunging ranula before considering surgery.

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