Mucocele

Its appearance is similar to that of a bubble filled with thick, soft liquid of variable size.

Oral mucocele originates in most cases in the lips, but can also occur in other parts of the oral cavity such as the tongue, palate or upper part of the mouth or oral floor.

These cysts are quite common and only a small percentage of cases require surgery or other treatment.

What is mucocele?

Mucocele or oral mucosal cyst appears as a transparent lump or swelling on the lips, tongue, palate or cheeks and frequently causes discomfort in the mouth when speaking or eating.

Currently, it is considered the most common benign lesion of the oral cavity. It is nothing more than a small mucous-filled cyst that forms in the regions where minor salivary glands are present. Studies estimate that 96% of mucoceles originate in the lower lip.

This lesion is not transmitted to others and is associated with alterations in the production of mucus and saliva of the oral mucosa. In most cases, the mucocele resolves spontaneously.

The mucocele can be superficial or deep, ranging in size from a couple of millimeters to 3 centimeters.

Histopathologically, a mucin extravasation phenomenon surrounded by a granulation tissue response with numerous foamy histiocytes is observed. Mucoceles are more common in children and young adults.

Causes

In general, we recognize two types of mucocele, depending on the cause:

• The first type is the overflow mucocele. This type of mucocele occurs as a result of trauma within the oral cavity. This trauma can occur, for example, at the level of the lower lip due to a piercing or due to a rupture of the salivary glands after bites.
• The second type of mucocele is called mucocele retention. This means that there has been an obstruction of the glandular duct within the oral cavity. This obstruction does not allow the glandular discharge to flow out, so it accumulates in the form of a mucocele.

Less frequently, it may be conditioned by other factors such as:

• Inflammations and genetic malformations.
• Scar tissue or even tumors.

Symptoms

Symptoms are usually not painful, especially if the mucocele is small. If it is painful, it is usually only sensitive to direct contact. Like most cystic lesions, the mucocele may resolve spontaneously, allowing drainage of the fluid accumulated inside, or it may require surgical drainage.

These lesions may recur and if they are large or bothersome it is advisable to resort to one of the various excision procedures available.

Consultation with a specialist is essential to evaluate the condition of the mouth and to understand the correct course of action to follow (also depending on where the mucocele occurs). Among other examinations, it is possible to perform:

• A two-dimensional radiograph (in the case of a mucocele in the oral cavity).
• Ultrasound (if in the neck or abdomen).
• Magnetic resonance imaging.
• Histological examination and biopsy to know the status of the cystic accumulation.
• If the mucocele is surgically removed, it is important to perform histological examination to fully understand the nature of the cystic accumulation.

Treatment of mucocele

The treatment of mucocele varies according to the symptomatology, the location and the usefulness of the treatment itself.

Some superficial forms undergo a process of spontaneous regression and therefore do not require treatment, resolving on their own after a short time.

However, in some cases it is necessary to aspirate the contents of the mucocele (an option that does not guarantee its complete resolution) or to perform a complete surgical excision of the mucocele.

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Mucocele: surgery

The surgical option is indicated in cases in which the mucocele represents an aesthetic or functional alteration that is disabling for the patient.

If left untreated, the mucocele may last for several weeks or months, with behavior characterized by periodic regression followed by recurrence or spontaneous rupture, with emission of a fibrous mucous fluid.

Surgical removal of the chronic mucocele or its marsupialization is followed by healing and allows the prevention of recurrences, as well as the reestablishment of the physiological canalization of the duct into the cavity. Endoscopic techniques are increasingly used to avoid scarring, aesthetic deformities, paresthesia and other side effects.

An injury not to be underestimated

Mucocele is a benign and painless condition that causes discomfort in the mouth. It disappears quickly and does not represent a serious health problem. However, this type of lesion should not be taken lightly, as its recurrence and persistence could be a sign of cancerous pathology.

Therefore, do not hesitate to consult a specialist if changes in the mouth persist over time or if other symptoms, such as pain and bleeding, are added. Physicians and dentists are the only ones qualified to make a diagnosis and prescribe treatment.