Jones 1

Question 1

What does a mucocele result from?

Answer 1

Rupture of a salivary gland duct with spillage of mucin into the connective tissue

Question 2

Who do mucoceles most commonly occur in?

Answer 2

Children and young adults

Question 3

Most common location of mucoceles

Answer 3

Lower Lip (60%), buccal mucosa, ventral tongue, floor of the mouth

Question 4

Histopathologic features of a mucocele

Answer 4

• Spilled mucin surrounded by granulation tissue
• Ruptured salivary gland duct may be evident
• Adjacent salivary glands often contain a chronic inflammatory reaction

Question 5

Treatment and prognosis of a mucocele

Answer 5

• May rupture and heal spontaneously
• Local surgical excision
• Adjacent minor glands should be removed
• Prognosis is excellent but may recur

Question 6

What is a ranula?

Answer 6

Mucocele that occurs in the floor of the mouth

Question 7

What causes a ranula?

Answer 7

Spillage of mucin from the sublingual gland

Question 8

Where is a ranula located?

Answer 8

Lateral to the midline

Question 9

What is a plunging or cervical ranula?

Answer 9

Spilled mucin is located below the mylohyoid muscle; may or may not have swelling in the floor of the mouth

Question 10

Histopathologic feature of a ranula

Answer 10

• Similar to a mucocele

- Spilled mucin elicits a granulation tissue response

Question 11

Treatment and prognosis of a ranula

Answer 11

Removal of the feeding sublingual gland and/or marsupilization

Question 12

What characterizes a cyst?

Answer 12

Lined by epithelium

Question 13

What causes a salivary duct cyst?

Answer 13

Most cases represent ductal dilation secondary to ductal obstruction

Question 14

Who do salivary duct cysts occur in?

Answer 14

Adults

Question 15

Where do salivary duct cysts occur?

Answer 15

Major glands: parotid

Minor glands: floor of the mouth, buccal mucosa, lips

Question 16

Histopathologic features of a salivary duct cyst

Answer 16

• Cystic cavity lined by cuboidal, columnar, or atrophic squamous epithelium
• Lumen contains mucoid secretions
• Lining epithelium may undergo oncocytic metaplasia

Question 17

Treatment and prognosis of salivary duct cyst

Answer 17

• Conservative surgical excision
• Major gland lesions: partial or total removal of the gland
• Recurrence is rare

Question 18

What is sialolithiasis?

Answer 18

Calcified structures within the ductal system

Question 19

What causes sialolithiasis?

Answer 19

Deposition of calcium salts around a nidus of debris: mucus, bacteria, epithelial cells, foreign body

Question 20

Most common location of sialolithiasis and why?

Answer 20

• Submandibular gland because the duct is long and tortuous and the secretions are thicker and more mucoid in consistency
• Also seen in the glands of the upper lip or buccal mucosa

Question 21

Who does sialolithiasis occur in?

Answer 21

Young and middle aged adults

Question 22

What symptoms accompany sialolithiasis?

Answer 22

Asymptomatic or associated with pain or swelling at mealtime

Question 23

How does a sialolith appear on an x-ray?

Answer 23

Radiopaque mass

Question 24

Histopathologic features of sialolithiasis

Answer 24

• Concentric laminations around a central nidus of amorphous debris
• Ductal metaplasia or sialadenitis

Question 25

Treatment and prognosis of sialolithiasis

Answer 25

• Small stones: sialogogues, moist heat, increase fluid intake
• Large stones: surgical excision, removed affected gland