Mucous cyst

Mucous cyst Mucous cyst is a benign cystic lesion, the mucosa of oral cavity minor salivary glands. Mucocel preferred name because these formations do not show their epithelial wall and cysts. The lesions may be located directly under the mucosa, superficial mucocele, the submucosa-classical or chorion mucocelele deep-deep mucocele. There are two types of mucocele according to histological characteristics of the cyst wall: a mucous extravasation, police formed a wall surrounded by mucous-92% granulation tissue and a mucous retention cyst wall epithelial-8%.
Multiple accused persons affected vesicles that spontaneously break leaving superficial ulcers. They fully recover within a few days. Deeper lesions present as papules in domcare become yellow in a few months. Patients with superficial cysts require no treatment. For multiple lesions is intralesional injection of triamcinolone and indicate electrodesicare. Treatment of choice is surgical excision for deep cysts classic. Cryosurgery is a therapeutic alternative, argon and carbon dioxide laser. Patients with this disorder have an excellent prognosis, recurrence is still frequent in the absence of associated salivary gland resection.
Pathogenesis and causes
Mucous cyst formation mechanism is not entirely clear, however, suggesting a traumatic than an obstructive etiology. Location frequent side formations on the surface of the lower lip supports the role of trauma as an etiological factor. Although obstruction may play a role in the etiology of mucous cysts was shown to bind to the mucous gland duct Cobia has not determined the formation of mucocele.
Signs and symptoms
Although patients of all ages can be affected, the most frequent cases of mucous cysts occurring in those younger than 30 years. Mucous retention cysts are more common in older people. Clinical presentation varies depending on the type and location of lesions. People with superficial cysts may experience the emergence of multiple vesicles that rupture and leave shallow ulcers. These lesions completely healed in a few days. Sometimes lesions recur in the same place. Classical cysts presents as dome-shaped papules, which become bright yellow as wax and disappear in a few months. A cyst located in deep tissue shows a slow growth phase, forcing masses firm root.
Physical Exam Clinical presentation depends on the depth of the lesion. Superficial cysts: mucus accumulates just under the lining of forcing small vesicles, translucent on the soft palate, buccal mucosa and retromolara region. While these vesicles are broken spontaneously or by trauma leaving pale ulcers or erosions. Cysts classic form it is presented as a collection of material in the submucosa mucosal swelling in producing high dome, well-defined, mobile and painless. These lesions have a smooth blue. Sizes range from several mm to cm, but 75% of lesions less than 1 cm. lesion surface can become white due to numerous irregularities and rupture and healing caused by trauma or puncture.
The most common location is on the lower lip, floor of mouth, cheeks, palate, dorsal surface of the tank retromolara and language. Lesions prevent the upper lip. Most large lesions affecting the mouth floor. They are called ranula due to similarity with an anatomical feature in the form of oral cavity frog bag. This collection of mucus may extend outside the oral cavity until the top or bottom medistinul head. When mucus accumulates in deep soft tissue masses appear large, painless Pink lining.
Diagnosis
Studies: Flat-ray showed soft tissue density Sonogram shows a round-table or hipoecogena lobe with well-defined edges -Computed tomography showed a well-defined formation water density Fine-needle aspiration is used to evaluate deep lesions, it demonstrates a few histiocite mucoid fluid and inflammatory cells.
Histological examination. It shows collections with eosinophilic mucus mixed with inflammatory cells present in the mucosa superficial or deep. Roigine epithelial mucin is only a fibroblast. Formations wall is composed of granulation tissue, while it is replaced by fibrocite and inflammatory cells. It is rare to see a wall derived from epithelial minor salivary glands. Lesions shows lymphocytic infiltrates, ductal distension, root degeneration and varying degrees of fibrosis. The differential diagnosis is made with the following conditions: aphthous stomatitis, lichen planus, lipomas, mucous pemphigoid, hemangiomas, fibromas, schwannoma.
Treatment
Patients with superficial cysts only require monitoring. For multiple cysts with Intralesional triamcinolone injections are recommended and electrodesicare.
Surgical therapy. Minor salivary glands should be excised only if persistent irritation. Treatment of choice for the classic deep cysts is surgical excision, which should include immediately adjacent glandular tissue. Cryosurgery with liquid nitrogen is a therapeutic alternative. After a week necrotic area is observed in the treated area. Later that separates from healthy tissue in 1-2 weeks, showing a surface reepitelizata. Benefits include the application process simple, minor discomfort during the procedure and the low incidence of complications such as infection, bleeding. There is the possibility of recurrence.
Another therapeutic strategy is argon laser therapy. The area is completely healed in two weeks. Advantages of cruichirurgiei consist in the absence of postoperative discomfort, swelling and irritation diminished and a reduced healing time. The disadvantage is the need for specialized equipment. Using carbon dioxide laser treatment has been tried mucocelelor. Shows the advantage of precise surgical techniques, and wound lack singerarii minimal. The prognosis of these patients is good. Recurrence is common if the salivary glands were not excised.