Inspect the Floor of the Mouth

The patient is asked to lift the tongue to the roof of the mouth, and the examiner inspects the floor of the mouth. Is there edema on the floor of the mouth? The opening of the subman-dibular gland, Wharton's duct, should be observed. The examiner should look for leukoplakia, erythroplakia, or a mass.

A ranula is a large mucous retention cyst on the floor of the mouth in association with submandibular and sublingual glands. The lesion is unilateral, painless, and bluish. It is lateral to the frenulum and is typically larger than a mucocele. As a ranula increases in size, there may be a reduction in tongue movement and difficulty in speech and swallowing. An example of a ranula is pictured in Figure 12-30.

Figure 12-30 Ranula.

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