Ranulas pose a challenging situation, both clinically and surgically, because of their location on the floor of the mouth, an area that exhibits tightly-netted vital structures. Several treatments have been proposed, including excision with or without removal of the sublingual gland, marsupialization with or without cauterization of the roof of the lesion, drainage of the lesion, and micro-marsupialization. It has been suggested that a modified micro-marsupialization technique can establish drainage of saliva and formation of new permanent epithelized tracts along the path of sutures, thereby reducing the recurrence. This paper presents a report of a ranula in a 12 year-old child that was successfully managed using a modified micro-marsupialization procedure.

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