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==Introduction==  

==Introduction==  

Salivary mucocoele is a term used to describe the abnormal accumulation of saliva outside of a salivary gland.  The cause of mucocoeles is often unknown but it may occur when salivary glands or ducts are ruptured. Mucocoeles are not true cysts because they are not lined by a layer of epithelium but by inflammatory connective tissue.  The sublingual and mandibular salivary glands are most commonly involved but any of the glands produce a mucocoele.  The saliva accumulates in one of three places:

Salivary mucocoele is a term used to describe the abnormal accumulation of saliva outside of a salivary gland.  The cause of mucocoeles is often unknown but it may occur where there is a lesion of the sublingual or mandibular salivary duct, or in one of the small ducts of the polystomatic sublingual salivary gland. Saliva leaks out and is not absorbed - causing the formation of a pseudocyst.

 

Mucocoeles are not true cysts because they are not lined by a layer of epithelium but by inflammatory connective tissue.  The sublingual and mandibular salivary glands are most commonly involved but any of the glands produce a mucocoele.  The saliva accumulates in one of three places:

*'''Cervical mucoceles''' are the most common, developing caudal and ventral to the mandible.  The swelling is usually to one side but may occur in the midline.

*'''Cervical mucoceles''' are the most common, developing caudal and ventral to the mandible.  The swelling is usually to one side but may occur in the midline.

*A '''ranula''' is an elongated swelling on the floor of the mouth.  They usually originate from the polystomatic sublingual glands and are therefore most often found beneath the tongue.  Due to its location, it may interfere with mastication and swallowing.

*A '''ranula''' is an elongated swelling on the floor of the mouth.  They usually originate from the polystomatic sublingual glands and are therefore most often found beneath the tongue.  Due to its location, it may interfere with mastication and swallowing.

'''Surgical drainage and removal of the damaged gland''' and duct is the treatment of choice.  Many of the salivary glands lie in close association with major structures of the head (including the cranial nerves and major blood vessels) and it may be advisable to refer such cases to a specialist centre for surgical removal.  If the mucocoele cannot be removed surgically, it may be drained periodically by percutaneous aspiration.  However, mucocoeles managed in this way rapidly recur and surgical removal of the tissue responsible for production of the saliva is preferable.

'''Surgical drainage and removal of the damaged gland''' and duct is the treatment of choice.  Many of the salivary glands lie in close association with major structures of the head (including the cranial nerves and major blood vessels) and it may be advisable to refer such cases to a specialist centre for surgical removal.  If the mucocoele cannot be removed surgically, it may be drained periodically by percutaneous aspiration.  However, mucocoeles managed in this way rapidly recur and surgical removal of the tissue responsible for production of the saliva is preferable.

'''Ranulas''' (which are within the buccal cavity) may be treated by '''marsupialisation''', in which the wall of the ranula is incised to allow the contents to drain into the mouth.  The rim of the ranula must then be sutured to the oral mucosa to hold the aperture open.  

'''Ranulas''' (which are within the buccal cavity) may be treated by '''marsupialisation''', in which the wall of the ranula is incised to allow the contents to drain into the mouth.  The rim of the ranula must then be sutured to the oral mucosa to hold the aperture open. Additionally, the monostomatic and polystomatic sublingual and mandibular salivary glands on the affected side can be surgically resected.

Pharyngeal mucoceles require complete gland and duct removal to alleviate dyspnoea and a temporary tracheostomy tube may be required in severe cases.

Pharyngeal mucoceles require complete gland and duct removal to alleviate dyspnoea and a temporary tracheostomy tube may be required in severe cases.

==Prognosis==

==Prognosis==

The prognosis is good for complete recovery.  Complications arise if the salivary glandular tissue is not completely removed (leading to recurrence of the mucocoele) or if major structures are damaged during the surgical procedure.

The prognosis is good for complete recovery.  Complications arise if the salivary glandular tissue is not completely removed (leading to recurrence of the mucocoele) or if major structures are damaged during the surgical procedure.

==Literature Search==

==Literature Search==

==References==

==References==

Hall, E.J., Simpson, J.W. and Williams, D.A. (2005) '''BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition)''' ''BSAVA''  

Hall, E.J., Simpson, J.W. and Williams, D.A. (2005) '''BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition)''' ''BSAVA''  

Merck & Co (2008) '''The Merck Veterinary Manual'''

Merck & Co (2008) '''The Merck Veterinary Manual'''

Guilford, W.G., Center, S.A., Strombeck, D.R., Williams, D.A. and Meyer, D.J. (1996) '''Strombeck's Small Animal Gastroenterology (3rd Edition)''' ''W.B. Saunders Company''

Verstraete, F. J. M. (1998) '''Self-Assessment Colour Review - Veterinary Dentistry''' ''Manson''

 

 

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[[Category:Salivary_Glands_-_Pathology]]

[[Category:Salivary_Glands_-_Pathology]]

[[Category:Oral Diseases - Dog]][[Category:Oral Diseases - Cat]]

[[Category:Oral Diseases - Dog]][[Category:Oral Diseases - Cat]]

[[Category:Expert_Review - Small Animal]]

[[Category:Expert_Review - Small Animal]]