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The third of the major salivary glands

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is the sublingual gland.

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This is a tubular alveolar gland,

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and it has mixed serous and mucus secretions.

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The submandibular gland is a little bit more

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mucinous and viscous in its saliva

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than the sublingual gland.

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And the parotid saliva is the

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most thin and serous.

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This is...

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The sublingual gland is located along the floor

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of the mouth, above the mylohyoid musculature

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and it runs in that space that is lateral

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to the genioglossus muscle and

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medial to the mylohyoid muscle.

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Within the sublingual gland and the sublingual

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space, you also find the lingual nerve and the

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submandibular duct, Wharton's duct, which is

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coursing along with the sublingual gland.

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It's interesting to look at a diagram of the

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ductal communication for the sublingual duct.

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So here you have the submandibular gland,

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and here you have the sublingual gland.

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And you see that the duct of the submandibular

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gland is coursing along in close association,

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just superficial to the sublingual gland.

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Well, there are lots of little ducts that will

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communicate with the Wharton's ducts of the

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submandibular gland from the sublingual gland.

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And these little ducts are seen on the diagram

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here coming off of the sublingual gland.

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And here you have the

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Wharton's duct which is coursing,

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it actually courses just superficial,

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not through the sublingual gland itself.

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The major sublingual duct is

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termed the Bartholin duct.

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And this Bartholin duct communicates

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with Wharton's duct.

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Then you have these tiny little ducts that I

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demonstrated on that diagram that will open

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either separately in the floor of the mouth,

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draining into the floor of the mouth itself

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or they can join Wharton's duct.

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Now when you do sialography of Wharton's duct,

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you rarely will see the Bartholin duct, and you

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never see these tiny ducts of Rivinus,

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which are those tiny little minor ducts.

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Here we have an MRI scan with T2 weighting,

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and we are able to identify nicely the sublingual

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space and the sublingual gland seen as the

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bright to intermediate tissue here.

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This dark tissue obviously represents muscle.

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And this is the mylohyoid muscle.

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Medial to it, you see this gray,

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bright tissue which represents the sublingual

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gland and the sublingual space,

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upon which the sublingual gland is residing.

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Separately here, we see a cystic structure

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which is in the sublingual space.

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And this cystic structure is

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what is known as a ranula.

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A ranula is due to obstruction of the

3:47

small glands in the sublingual space,

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mostly...

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most likely from the sublingual gland,

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but it can also be from minor

3:55

salivary gland tissue.

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So this is the ranula.

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The ranula is separated into two different

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varieties, and the variety of the ranula is

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separated by whether or not it pierces

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the mylohyoid muscle.

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These are two different cases.

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This

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is a stretched

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mylohyoid muscle.

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This

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is a perforated

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mylohyoid muscle.

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So this ranula goes through

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the mylohyoid muscle.

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This one is still contained

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by the mylohyoid muscle.

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The term for this is the simple ranula.

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The term for this is the plunging ranula.

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Or people will say the deep.

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So depending upon the integrity

5:14

of the mylohyoid muscle,

5:18

we separate simple from plunging ranulas.

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This is important because simple ranulas are

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treated intraorally by opening the

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mouth and resecting the ranula,

5:32

removing the ranula intraorally.

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Whereas deep plunging ranulas

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are operated from a cervical approach, that is,

5:43

from the neck and then reached

5:45

up and pulled down that way.

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Simple versus plunging ranula,

5:50

both of which are due to obstruction of the

5:53

ductal tissue in the sublingual space.