Back in October of 2016, we were at the orthodontist and the orthodontist told me there was something really weird going on in the floor of Talmage's mouth, something he hadn't seen before. It was a big bubble. He encouraged me to check it out and recommended an oral surgeon. The one we saw was a young guy. He knew that the bubble was a ranula (which is Latin for frog, like the bubble under a frog's mouth) and full of saliva but had never seen one before. He didn't inspire me with confidence so I made an appointment with a different oral surgeon who had done Garrett's jaw surgery. When we went to see him, he said oral surgeons deal more with the bones of the skull and for soft tissue work, we should go see an Ear, Nose, and Throat doctor who had more experience with this. He referred us to Dr. Robert Hunter in Salt Lake.
So we went to see Dr. Hunter. He said that ranulas were uncommon--he saw maybe 6 cases per year but he knew how to deal with them. First, he wanted to try putting a stitch in the ranula to drain the saliva and see if the hole would remain open. So he put a stitch in, right there in the office. Unfortunately it came out on the way home because the tissue was so thin. All the saliva drained but within a short time the tissue closed up again and the ranula was back. The ranula is caused by a blocked salivary gland/duct so the saliva builds up under the skin because it isn't draining normally.
We went back in a week and the doctor then sent us for an MRI to see how deep it went and which salivary gland was involved. So we did that and then we went back to the doctor to talk about it. If you're keeping track, we'd had 6 appointments so far to see about this ranula that was still there.
So then, the next step was to get a minor surgery to "marsupialize" the ranula. The idea was to cut the ranula open and stitch the edges of that tissue to the perimeter of the floor of the mouth. The main problem was that this surgery had less than a 50% chance of solving the problem. But the surgery that would definitely solve the problem--removing the salivary gland and duct--is so invasive and difficult (and painful) that the doctor really thought we should try the minor one first.
Taking care of the ranula was not urgent--it wasn't malignant and Talmage barely knew it was there since it grew so gradually. So we took a break from the doctor in December and made our appointment for the beginning of January. We went up to the Intermountain Medical Center and had the surgery about three weeks ago.
The recovery was not as easy as we were expecting or hoping. Eating was pretty challenging for Talmage for almost a week. Teenage boys are pretty fond of eating so this was really hard. But he survived. After two weeks, we went back for a follow-up. The doctor said there was still a tiny hole that saliva was draining through--which was the goal--and that we could hold off on the major surgery. He encouraged Talmage to keep pumping saliva through that hole to keep it open. Hopefully it will continue to stay open!
So we went to see Dr. Hunter. He said that ranulas were uncommon--he saw maybe 6 cases per year but he knew how to deal with them. First, he wanted to try putting a stitch in the ranula to drain the saliva and see if the hole would remain open. So he put a stitch in, right there in the office. Unfortunately it came out on the way home because the tissue was so thin. All the saliva drained but within a short time the tissue closed up again and the ranula was back. The ranula is caused by a blocked salivary gland/duct so the saliva builds up under the skin because it isn't draining normally.
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| You can see the ranula under his tongue next to his teeth. |
We went back in a week and the doctor then sent us for an MRI to see how deep it went and which salivary gland was involved. So we did that and then we went back to the doctor to talk about it. If you're keeping track, we'd had 6 appointments so far to see about this ranula that was still there.
So then, the next step was to get a minor surgery to "marsupialize" the ranula. The idea was to cut the ranula open and stitch the edges of that tissue to the perimeter of the floor of the mouth. The main problem was that this surgery had less than a 50% chance of solving the problem. But the surgery that would definitely solve the problem--removing the salivary gland and duct--is so invasive and difficult (and painful) that the doctor really thought we should try the minor one first.
Taking care of the ranula was not urgent--it wasn't malignant and Talmage barely knew it was there since it grew so gradually. So we took a break from the doctor in December and made our appointment for the beginning of January. We went up to the Intermountain Medical Center and had the surgery about three weeks ago.
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| Pre-surgery. |
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| Post-surgery, recovering from anesthesia. |
The recovery was not as easy as we were expecting or hoping. Eating was pretty challenging for Talmage for almost a week. Teenage boys are pretty fond of eating so this was really hard. But he survived. After two weeks, we went back for a follow-up. The doctor said there was still a tiny hole that saliva was draining through--which was the goal--and that we could hold off on the major surgery. He encouraged Talmage to keep pumping saliva through that hole to keep it open. Hopefully it will continue to stay open!
Update: 5 years later, it is still fixed and not a problem! Hurray! I would recommend Dr. Hunter if he is even still practicing after all this time. He did a good job and was very professional.
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