Trudging home after a long day, all you want is to put your feet up and sink your teeth into a nice warm meal. As you open the door to your apartment, you are accosted by the tantalizing aromas of a simmering stew. Salivating, you pick a spoon to sample the dish, when you just happen to miss the spoon and bite down on your lip. Cursing, you ignore the pain and continue eating the stew. The next day, however, you begin to see a small bump on your lip where you bit down, but it disappears the following day. What just happened?
What you most likely had was an oral mucocele, the swelling of connective tissue in the oral mucosa that consists of a collection of fluid called mucin. The most common locations to find a mucocele are the inner surfaces of the lower lip, the inner side of the cheek (known as the buccal mucosa), on the upper tongue, and on the floor of the mouth. Primary causes include a ruptured salivary gland duct usually caused by local damage, such as biting ones’ lip or an obstructed/ruptured salivary duct. Some mucoceles have a bluish translucent color, and they are more commonly found in children, adolescents, and young adults.
Image Source: Smith Collection/Gado
Oral mucoceles vary in size from 1 millimeter to several centimeters, and they usually are slightly transparent with a blue tinge. Upon palpation, mucoceles may appear moveable but can also be firm. They may last from days to years and can potentially have recurrent swelling with occasional spontaneous disappearance and resolution.
If recovery does not occur fast enough or at all, patients may elect to proceed with surgical excision. This is typically an outpatient surgery in which otolaryngologists and oral or dental surgeons perform a small incision with local anesthesia. The ball-shaped mucocele is then cut out of the excision along with surrounding minor salivary glands. Dissolvable sutures are put in place, with minimal postoperative care and pain. Other options include marsupialization, in which a new duct is created, allowing saliva to leave the salivary gland. In this procedure, the doctor places a stitch through the mucocele and ties a knot. Saliva is gently squeezed out, and the stitch is removed in about a week.
Altogether, if monstrous mucoceles manifest in the mouth, take yourself to your nearest physician or otolaryngologist for a quick check. Stay tuned for more ENT Weekly!
Feature Image Source: Justin Chin
