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| CASE REPORT |
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| Year : 2021 | Volume
: 7
| Issue : 1 | Page : 73-75 |
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Congenital mucocele of the tongue in a neonate
Zaheer Hasan, Digamber Chaubey, Vinit Kumar Thakur, Sujit Kumar
Department of Pediatric Surgery, IGIMS, Patna, Bihar, India
| Date of Submission | 08-Jan-2021 |
| Date of Decision | 20-Mar-2021 |
| Date of Acceptance | 25-Mar-2021 |
| Date of Web Publication | 28-Jun-2021 |
Correspondence Address:
Zaheer Hasan
D 6/2, IGIMS Patna 14, Patna, Bihar
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/jigims.jigims_5_21
Congenital mucocele presenting over the anterior dorsum of the tongue is an uncommon condition where the infant is usually presented with fluctuant swelling in the oral cavity rarely with respiratory distress along with feeding difficulty. It was successfully managed by initial aspiration, followed by marsupialization in a neonate.
Keywords: Congenital, infant, marsupialization, mucocele
How to cite this article:
Hasan Z, Chaubey D, Thakur VK, Kumar S. Congenital mucocele of the tongue in a neonate. J Indira Gandhi Inst Med Sci 2021;7:73-5 |
| Introduction | |  |
Congenital mucocele of the tongue is an uncommon condition where the infant is usually presented with fluctuant swelling in the oral cavity rarely with respiratory distress along with feeding difficulty. The incidence of congenital mucocele is 1.82/100,000 live birth mainly manifesting in the second decade of life.[1]
| Case Report | | |
A 2-month-old male presented to the pediatric surgery outpatient clinic with respiratory distress and difficulty while breastfeeding for the last 1 week. The child had a history of swelling of the tongue since birth [Figure 1] which was kept increasing day by day. No antenatal ultrasonographic abnormality was detected. The child was not able to close his mouth properly along with the history of excessive drooling of saliva. The baby had been delivered by spontaneous vaginal delivery and cried soon after birth. On the examination, swelling was found over the dorsum of the tongue anteriorly which was globular and 5 cm × 4 cm in size. It was tense and a short frenulum was found. The color of the swelling was similar to that of the oral mucosa. The tongue was unusually protruded outward [Figure 2]. Because of large size of the lesion with the macroscopic appearance of a mucocele, it was first aspirated (5 ml) and the content was analyzed. Later on, marsupialization of the cyst was done under general anesthesia with orotracheal intubation along with pharyngeal packing [Figure 3]. After 6 months of follow-up, no recurrence was noted [Figure 4].
| Discussion | | |
Congenital cystic lesions of the oral cavity are rare in occurrence and commonly present as mucocele. Mucocele can cause different symptoms based on their location, size, and the age of the patient. A mucocele of the posterior dorsal tongue can cause troublesome breathing and swallowing. Most mucoceles, about 78%, are located at the lower lip, an area easily subject to trauma.[2] The overall incidence of tongue mucocele is about 10% which is mostly situated posteriorly and rarely anteriorly.[3] Mucoceles more anteriorly can give occlusion problems of the mouth as present in our case.[4] Mucoceles can also arise following duct obstruction with the rupture of duct (extravasation mucocele) or without rupturing of the gland (retention mucocele).[5] Mucocele can arise as a result of failure of duct recanalization as in congenital cases.[6] Out of three sets of salivary glands found in the tongue, mucocele usually arises from the anterior lingual gland also known as the serous gland of Blandin and Nuhn which is highly uncommon before school going age group. The short frenulum found in this neonate was due to abnormalities during the fusion process of the three tongue buds which ultimately form the anterior two-third of the tongue. When, during development, the two distal tongue buds stay separated from each other for a longer period of time, the acini in the anterior lingual glands can expand distal and be found deep inside the tongue. These fusion problems also create possibilities for the ducts to drain into the medial sulcus of the tongue, enabling a mucocele to form at the anterior dorsal side of the tongue.[7] Swelling over the anterior tongue should be differentiated from foregut duplication and ranula which is typically situated in the floor of the mouth. Other common swelling should be differentiated are hemangioma, lipoma, papilloma, adenoma, lingual teratoma, and fibroma. If mucocele is detected antenatally with threatening airway obstruction, extrauterine intrapartum procedure should be contemplated.
Congenital mucocele is rare and can be successfully managed by marsupialization, especially in the neonatal setting.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
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| 2. | Hayashida AM, Zerbinatti DC, Balducci I, Cabral LA, Almeida JD. Mucus extravasation and retention phenomena: A 24-year study. BMC Oral Health 2010;10:15. |
| 3. | Boulos MI, Cheng A. Case 1: What is that in your mouth? Paediatr Child Health 2006;11:107-8. |
| 4. | Wong Chung JE, Ensink RJ, Thijs HF, van den Hoogen FJ. A congenital mucocele of the anterior dorsal tongue. Int J Pediatr Otorhinolaryngol 2014;78:1179-81. |
| 5. | Kheur S, Desai RS, Chintamani KA. Mucocele of the anterior lingual salivaryglands (Glands of Blandin & Nuhn). Indian J Dent Adv 2010;2:153-6. |
| 6. | Gul A, Gungorduk K, Yildirim G, Gedikbasi A, Ceylan Y. Prenatal diagnosis and management of a ranula. J Obstet Gynaecol Res 2008;34:262-5. |
| 7. | Wong Chung JE, Ensink RJ, Thijs HF, van den Hoogen FJ. A congenital mucocele of the anterior dorsal tongue. Int J Pediatr Otorhino Laryngol 2014;78:1179-81. |
[Figure 1], [Figure 2], [Figure 3], [Figure 4]
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