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Recurring mucocele even after surgery

05/13/2008

Question:

My nine-year-old daughter was diagnosed with a mucocele. We then went to an oral surgeon and she had surgery to remove the mucocele. It wasn`t even a week later and she had another mucocele. Was her surgery unsuccessful and does she need another surgery with a different oral surgeon? Are there any other alternatives to surgery?

Answer:

The mucocele is a harmless condition caused when the duct of one of the minor salivary glands is ruptured. There are dozens of minor salivary glands that lay just beneath the lining of the mouth, and each has a little tube (called a duct) that leads from the gland to the surface of the mouth. When the duct is cut – which happens fairly frequently, presumably due to small episodes of trauma – the mucus that the gland produces collects under the mucosa (lining of the mouth), producing the equivalent of a “water balloon”.

Often the mucus deposit will stretch the mucosa to the point of breaking, causing release of the mucus and collapse of the mucocele. When the mucosa heals, however, the duct usually does not connect back to the surface, so the process repeats itself.

Surgery to remove the mucus deposit and the gland responsible for creating it is usually necessary to clear the problem up. Trying to identify the responsible gland, removing it, and not causing damage to the ducts of the adjacent glands can be tricky. We occasionally see recurrence of mucoceles, and recurrence is not necessarily related to the skill of the surgeon. Surgery is really the only reasonable way to treat this condition.

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