[Little frog in the mouth: a visual diagnosis?] / Fröschlein im Mund: eine Blickdiagnose?

Ranula, from the Latin "little frog", is a retention cyst filled with saliva in the oral cavity. Simple ranulas most commonly affect the sublingual gland and typically present as a hemispherical bluish cyst on the floor of the mouth, making it a visual diagnosis. A 7-year-old girl presented with a swelling on the underside of the tongue, an uncommon location for a ranula that made diagnostic assignment difficult. The optimal treatment of a ranula is still controversial in the literature. Many authors favor surgery as the treatment of choice. Our case shows that a watch and wait approach with simple mechanical pressure on the cyst can be sufficient.

A surgical case report of an epiploic hernia - A mobile right colon herniating through the foramen of Winslow.

INTRODUCTION: An Epiploic Hernia is an extremely rare type of abdominal hernia with <0.1 % incidence where the bowel or other intra-abdominal contents herniate through the Foramen of Winslow. A case of an Epiploic hernia in a middle-aged female is presented here. PRESENTATION OF CASE: A woman in her 60s was admitted to a tertiary level hospital with severe right sided intermittent upper abdominal pain associated with nausea, bloating and constipation. The symptoms were thought to be due to biliary colic and managed conservatively. Since the symptoms persisted and a computed tomography scan of abdomen was organized. CT scan showed that the caecum was in the upper left quadrant. A laparoscopy was performed and demonstrated that her right colon was mobile herniating through the Foramen of Winslow into the lesser sac. The hernia was reduced, and the bowel was viable. The patient was discharged with no complications. DISCUSSION: There have been case reports of small bowel as the content of the hernia with lesser occurrences of caecum, ascending colon, transverse colon, gall bladder, omentum, or Meckel's diverticulum. A caecal herniation through the Foramen of Winslow is reported only with an incidence of 0.02 %. <10 % of these Epiploic hernias are diagnosed preoperatively making it a potentially life-threatening condition if not treated promptly due to high risk of bowel strangulation and mortality of up to 50 %. CONCLUSION: A high index of suspicion is needed for the diagnosis of this internal hernia and radiological investigation is fundamental in making this diagnosis for allowing prompt surgical treatment.

A Twisted Cecum: Herniation and Volvulus of the Cecum Through the Epiploic Foramen.

Herniation of the cecum, terminal ileum, and ascending colon through the epiploic foramen is an uncommon presentation of an internal hernia. An 82-year-old female presented with a small bowel obstruction; Computed Tomography (CT) imaging showed a herniation of the terminal ileum, cecum, and ascending colon through the foramen of Winslow into the lesser sac, with cecal volvulus. Prompt surgical treatment included laparotomy and reduction of the hernia, followed by an extended right hemicolectomy with primary anastomosis and functional closure of the epiploic foramen. This report reviews the natural history and management of this rare pathology.

Management of Mucocele of the Glands of Blandin-Nuhn With a High-Intensity Laser: A Case Report.

Introduction: The glands of Blandin-Nuhn are mucous and serous salivary glands situated on both sides of the midline of the ventral surface of the tongue. In this area, a mucocele generally results from trauma. The diagnosis of mucoceles is based on clinical and histopathological examinations and the recommended treatment is surgical excision. Case Report: This report describes a case of mucocele of the glands of Blandin-Nuhn (MGBN) affecting a 20-year-old male. Oval-shaped swelling with a smooth and bright surface of soft consistency was observed on the ventral surface of the individual's tongue. The diagnostic hypothesis was mucocele. Surgical excision was performed in a single session with a diode laser. A histopathological examination revealed mucus extravasating into connective tissue, with foamy macrophages and granulation tissue. Conclusion: The high-intensity laser was a safe and effective tool for treating MGBN. No need for a suture, minimal or no intraoperative bleeding, and a minimal report of pain and edema by the patient were observed. A diode laser may be a helpful tool because it is less invasive and it is safe and effective.

Diode Laser Excision of Blandin-Nuhn Mucocele.

The glands of Blandin and Nuhn are mixed mucous and serous glands that are embedded within the musculature of the anterior tongue ventrum. The differential diagnosis for lesions in that area is often challenging and includes other salivary and nonsalivary lesions. This affects decision-making, surgical management, and measures to prevent complications. Unlike conventional cold blade surgery, diode laser use may simplify such treatment.

Mucoceles of the anterior ventral surface of the tongue and the glands of Blandin-Nuhn: 5 cases.

INTRODUCTION: Mucoceles are cystic diseases of the oral mucosa. The most common are ranula and mococeles of the lower lip. Blandin and Nuhn mucoceles, which develop at the ventral side of the tongue, are rare benign lesions. They are often misdiagnosed and sometimes confused with ranula. The recommended treatment is a complete surgical excision of the gland. PATIENTS AND METHODS: We describe 5 clinical cases managed in service between 2009 and 2016. Clinical cases are presented in order to detail their clinical history, paraclinical and treatment. RESULTS: The clinical appearance is a longitudinal swelling of the ventral surface of the tongue, parallel to the frenulum. The volume of the swelling is variable; it is normally around 30 × 10 mm. The paraclinical (ultrasound, CT, MRI, or ponction) could be performed. CT showed an cyst located on the ventral surface of the tongue, with liquid density. Blandin and Nunh mucocele were strictly anechogenic. MRI confirms the liquid content of this cyst (low T1signal, high T2signal and no post-contrast-enhanced). The resection of Blandin and Nuhn glands should respect the sublingual gland, the lingual nerve and the lingual veins in the mouth floor. CONCLUSION: This study demonstrates that Blandin and Nuhn mucoceles must be understood and recognised to propose complete excision of the Blandin and Nuhn gland and avoid recurrence.

Simultaneous, congenital, mucocoele of the Blandin-Nühn glands and teratoma of the tongue: early management and follow up at one year.

Mucocoele of the Blandin-Nühn glands and teratomas of the tongue are rare in newborn babies. We present what is to our knowledge the first documented case of both at the same time, and describe management and follow up over 12 months after the birth. Prenatal diagnosis defined the treatment plan during delivery to establish an airway for the baby promptly. A normal delivery is possible if the cyst is anterior, and can be punctured during delivery. Delayed excision reduces the possibility of oedema and obstruction of the airway, ensures complete resection, avoids recurrence, and confirms the diagnosis. Mucocoeles are classified as extravasation or retention types; our observation supports the hypothesis of a "malformative type". A long follow-up is essential to monitor macroglossia, open bite, and the development of the mandible.

Solitary nodular lesion of tongue- a rare entity.

The solitary, nodular lesions of the oral mucosa present a diagnostic dilemma to the dentist with their analogous presentation. The lesions that appear on the tongue, a soft muscular organ are distinct and even rarer with varied manifestations. Oral mucosa presents lesions of the tongue in all age groups that may range from a small nodular swelling and ulcer formation in an infant of a few days old to an ulcer or a lesion in a 70-year-old. The reason for the appearance of an ulcer may be trauma to the soft tissues in an infant may be due to the presence of natal teeth to the presence of a sharp tooth in the older individuals. These lesions have to be clinically and histologically correlated for the final outcome of the diagnosis, so that there is no chance of any recurrence. We present a unique case of a solitary nodular lesion on the ventral surface of tongue On a 6 year female, where there was a recurrence after surgical excision and after an unusual therapy of non surgical resolution, no recurrence was observed.

Oral mucocele: A clinical and histopathological study.

BACKGROUND: Oral mucocele is the most common benign minor (accessory) salivary gland lesion, caused due to mechanical trauma to the excretory duct of the gland. Clinically they are characterized by single or multiple, soft, fluctuant nodule, ranging from the normal color of the oral mucosa to deep blue. It affects at any age and is equally present in both sexes with highest incidence in second decade of life. They are classified as extravasation or retention type. OBJECTIVES: To analyze the data between 2010 and 2011 of, clinically and histopathologically diagnosed 58 oral mucoceles for age, gender, type, site, color, cause, symptoms and dimension. RESULTS: Oral mucoceles were highly prevalent in the age group of 15-24 years, were seen in 51.72% of males and 48.28% of females, with a ratio of 1.07:1. The extravasation type (84.48%) was more common than the retention type (15.52%). The most common affected site was lower lip (36.20%) followed by ventral surface of the tongue (25.86%). The lowest frequency was observed in floor of mouth, upper lip and palate. The maximum numbers of mucoceles were asymptomatic (58.62%), and the color of the overlying mucosa had color of adjacent normal mucosa (48.28%). It was also observed that most of the mucoceles had diameter ranging from 5 to 14 mm. The causative factors of the lesion were lip biting (22.41%), trauma (5.18%) and numerous lesions (72.41%). CONCLUSION: Oral Mucoceles are frequently seen in an oral medicine service, mainly affecting young people and lower lip, measuring around 5 to 14 mm and the extravasation type being the most common.

Mucocele of the glands of Blandin-Nuhn: a case report.

Mucoceles arising from the Blandin Nuhn glands are uncommon benign lesions of the oral cavity, which by their clinical presentation may be confused with more serious diseases such as vascular lesions, pyogenic granulomas, polyps, or squamous papillomas; thereby, it is convenient to be aware of the characteristics of this entity to guide the accurate and timely diagnosis and treatment. Herein, we present a case of a 10-year-old patient with a recurrent lesion of this type, which required surgical excision and marsupialization of the same, with no evidence of recurrence during follow-up.

Los mucoceles originados de las glándulas de Blandin Nuhn son lesiones benignas poco comunes de la cavidad oral, que por su presentación clínica pueden ser confundidas con patologías de mayor gravedad como lesiones vasculares, granulomas piógenos, pólipos o papilomas escamosos; por lo cual es conveniente conocer las características particulares de esta entidad para orientar de manera precisa y oportuna su diagnóstico y tratamiento. Se presenta el caso de una paciente de 10 años con una lesión recidivante de este tipo, que requirió de extirpación quirúrgica y marsupialización de la misma, sin evidencia de recurrencia durante el seguimiento.

A novel technique for the management of blandin-nuhn mucocele: a case report.

Mucocele, a common benign cystic lesion of minor salivary gland and associated ducts develops following extravasation or retention of mucous material in the subepithelial tissue. Occurrence of mucocele of tongue is considered less frequent when compared to a higher incidence of mucocele in the lower lip of young patients. Different modalities of treatment, such as conventional surgical excision followed by newer techniques like cryosurgery, electrocautery have been proposed to completely remove the lesion and reduce the chances of recurrence. Herewith, we report a novel treatment technique using alginate impression material to aid in complete excision of mucocele of glands of Blandin-Nuhn. How to cite this article: Kumaresan R, Karthikeyan P, Mohammed F, Fairozekhan TA. A Novel Technique for the Management of Blandin-Nuhn Mucocele: A Case Report. Int J Clin Pediatr Dent 2013;6(3):201-204.

Mucocele of the glands of blandin-nuhn in children: a clinical, histopathologic, and retrospective study.

BACKGROUND: The anterior lingual salivary glands (glands of Blandin-Nuhn) are mixed mucous and serous glands that are embedded within the musculature of anterior tongue ventrum. AIM: The present study was designed to describe the clinical and histopathological features. MATERIAL AND METHODS: We investigated the clinical and histopathologic features of 30 cases of mucocele of glands of Blandin-Nuhn. All the cases were seen in the department of pedodontics. RESULTS: All the lesions were located on the ventral surface of the tongue. Lesions were situated at the midline in 24 patients and laterally in 6 patients. All the lesions were surgically treated. There was female predominance, and most patients were younger than 15 years. CONCLUSION: Histopathological examination showed extravasation type of mucocele, suggesting that trauma may be a frequent initiating factor. All the patients were younger than 15 years.

Mucocele de las glándulas Blandin-Nuhn, aspectos patológicos y terapéuticos, a propósito de dos casos clínicos / Mucocele of the glands of Blandin-Nuhn

Las glándulas de Blandin-Nuhn son un grupo de pequeñas glándulas salivales mucoserosas, ubicadas en el espesor de los haces musculares de la zona anterior de la cara ventral de la lengua. Los mucoceles de las glándulas de Blandin-Nuhn son poco frecuentes. Se revisa la literatura y se presentan dos casos de mucocele de las glándulas de Blandin-Nuhn, ambos casos eran lesiones exofíticas, indoloras, una de ellas asociada a trauma. Los mucoceles de las glándulas salivales linguales anteriores deben ser resecados hasta el plano muscular para evitar la recidiva. Como esta lesión puede ser confundida con otras patologías, se recomienda su estudio histopatológico para evitar diagnósticos errados.

The Blandin-Nuhn glands are a small group of mucous serous salivary glands, located in the thickness of the muscle bundles of the anterior ventral side of the tongue. Mucocele of the glands of Blandin-Nuhn has been reported as unusual. We review the literature and present two cases of mucocele of the glands of Blandin-Nuhn, both cases were exophytic lesions, painless, one associated with trauma. Mucoceles of the salivary glands should be resected up to the muscular plane to avoid recurrence. Because this lesion may be confused with other diseases, it is recommended an histopathological exam to avoid misdiagnosis.

Mucocele en glándulas de Blandin-Nuhn o glándulas linguales anteriores: reporte de un caso / Mucocele in glands of Blandin-Nuhn or previous lingual glands: a case report

El mucocele es un quiste que consiste en una colección de mucina proveniente de la ruptura del conducto de una glándula salival, por lo general asociado a trauma local. Se describe un caso de un paciente masculino de 22 años de edad, natural y procedente de Caracas que acude a consulta por presentar lesión en la cara ventral de la lengua desde hace aproximadamente 3 meses que le imposibilita comer y hablar. Al examen clínico intrabucal, se presenta una lesión de 2x2 cm de extensión, del mismo color de la mucosa, dolorosa a la palpación, la cual imposibilita la movilidad de la lengua. El tratamiento consistió en la marsupialización de la lesión

The mucocele is a cyst that consists of a collection of mucin from the break of the conduct of a salivary gland, generally associated with local trauma. There is described a case of a 22-year-old male patient , natural from Caracas who comes for presenting injury in the ventral surface of the tongue from approximately 3 months that disables him to eat and to speak. To the clinical examination, appears an injury of 2x2 cm of extension, of the same color of mucous, painful to the palpation, which disables the mobility of the tongue. The treatment consisted of the marsupialization of the injury