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A Pain in the Neck

A Pain in the Neck. 7 th Annual Pediatric Otolaryngology Symposium October 4, 2012 Melissa M Dziedzic APRN, CORLN. This is Laura. Both inside…. …and out. History. 10 day h/o right sided neck mass with pain Started with swelling underneath the tongue No fever or preceding illness

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A Pain in the Neck

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  1. A Pain in the Neck 7th Annual Pediatric Otolaryngology Symposium October 4, 2012 Melissa M Dziedzic APRN, CORLN

  2. This is Laura • Both inside…..

  3. …and out

  4. History • 10 day h/o right sided neck mass with pain • Started with swelling underneath the tongue • No fever or preceding illness • Decreasing tenderness-using Advil • Affecting ability to eat • Evaluated by her PCP and prescribed Augmentin

  5. Physical Examination • Swelling on the right side of her neck • Soft palpable mass in the right sublingual area (tender) • Semi-firm mobile mass in the right submandibular area (tender) • Diagnosis: Sialectasis vs Infected Ranula • Plan: Extend Augmentin and add heat, massage and sialogogues

  6. 2 weeks later…

  7. MRI

  8. Ranula • Cyst underneath the tongue formed when the salivary duct is obstructed • Commonly d/t trauma>secretory back pressure >acini rupture>mucous extravasation >cystic formation • Most frequently stems from sublingual gland • Normally above mylohyoid muscle

  9. Excision of the Ranula

  10. Postoperative Care • Pain Management • Oral Antibiotics • Antibiotic Rinses • No Diet Restrictions • No Activity Restrictions

  11. Postoperative Visit

  12. Questions?

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