Sublingual Gland Cysts: Treatment Options and Concerns

Treatment of sublingual gland cysts?

Hello, Dr.
Cheng.
My family member has recently been diagnosed with a submandibular gland cyst and is unable to visit a regular clinic due to discomfort.
The doctor prescribed medication, but indicated that if there is no reduction in swelling, surgery at a larger hospital may be necessary.
However, after taking the medication, the cyst has only grown larger.
We searched for information online and have a few questions:
1.
My family member is somewhat resistant to the idea of removing the submandibular gland.
What is the recurrence rate if the gland is not removed? Are there any alternative treatments available?

2.
During the surgery, will the anesthesia be local or general? We have seen some sources stating that general anesthesia is required, which makes us a bit concerned.
3.
In the time leading up to the decision about surgery, are there any methods to help reduce the size of the cyst? My family member has been considering puncturing it, but I am worried about potential complications from the wound.
Are there any better temporary solutions to address this issue?
I apologize for the trouble, and thank you for your assistance.

S, 30~39 year old female. Ask Date: 2014/08/18

Dr. Zheng Jueyi reply Otolaryngology

Hello, sublingual gland cysts are often caused by the blockage of the small salivary gland ducts, leading to the accumulation of saliva and subsequent swelling.
Most cases require surgical intervention for complete resolution.
While aspiration can temporarily relieve the cyst by allowing saliva to drain, the cyst may re-enlarge after a few days as the puncture site heals.
Aspiration only provides temporary relief.
Regarding whether the surgery should be performed under local or general anesthesia, it is recommended to consult a physician for evaluation, as this decision depends on factors such as the size of the cyst, the patient's anxiety about the procedure, and other clinical considerations.
Wishing you safety and health.
Sincerely, Dr.
Jue-Yi Cheng, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2014/08/18

More Info

Sublingual gland cysts, also known as ranulas, are fluid-filled sacs that can develop in the sublingual glands located under the tongue. These cysts can cause discomfort and may interfere with normal oral function. Understanding the treatment options and concerns surrounding these cysts is essential for making informed decisions about care.

1. Recurrence and Non-Surgical Options: If your family member is hesitant about surgical removal, it’s important to note that the recurrence rate of sublingual gland cysts can be significant if they are not surgically excised. Non-surgical options, such as medication, may provide temporary relief or reduce inflammation, but they are unlikely to eliminate the cyst entirely. The cyst may continue to grow or recur if the underlying issue is not addressed. In some cases, aspiration (draining the cyst) can be performed, but this is often a temporary solution, as the cyst may refill with fluid. Therefore, while there are non-surgical options, they may not be effective long-term solutions.

2. Anesthesia During Surgery: When it comes to surgical intervention, the type of anesthesia used can vary based on the complexity of the procedure and the patient's overall health. In many cases, local anesthesia is sufficient for the removal of a sublingual gland cyst, allowing the patient to remain awake and aware during the procedure. However, if the cyst is large or if there are complications, general anesthesia may be recommended. It’s crucial to discuss these options with the surgeon, who can provide guidance based on the specific circumstances of the case.

3. Managing Symptoms Before Surgery: While waiting for a surgical decision, there are limited options for reducing the size of the cyst. Warm compresses may provide some relief from discomfort, but they are unlikely to reduce the cyst’s size significantly. It’s important to avoid attempting to puncture or drain the cyst at home, as this can lead to infection, bleeding, or other complications. Instead, encourage your family member to follow up with their healthcare provider for ongoing evaluation and management.

In summary, while there are non-surgical options available for managing sublingual gland cysts, surgical removal is often the most effective way to prevent recurrence. The choice of anesthesia will depend on the specific circumstances of the case, and it’s essential to avoid home remedies that could lead to complications. Open communication with the healthcare provider is key to addressing concerns and making an informed decision about treatment. If your family member continues to experience discomfort or if the cyst grows, it may be necessary to reconsider surgical options for long-term relief.

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