ABSTRACT Objective To systematically review and compare recurrence rates associated with different management strategies for simple and plunging ranulas. Methods A PRISMA‐guided search of PubMed, Embase, Web of Science, Scopus, and CINAHL was performed. Studies reporting post‐treatment outcomes of ranulas with clearly defined initial management strategies were included. Two reviewers independently screened studies and extracted data on ranula subtype, treatment details, duration of follow‐up, and recurrence. Risk of bias was assessed using study design‐appropriate tools. Given the predominance of retrospective case series with heterogenous designs and incomplete outcome reporting, quantitative pooling was not feasible; results were synthesized descriptively. Results Seventy‐one studies comprising 809 patients (563 simple, 246 plunging) met inclusion criteria. Excision with ipsilateral sublingual gland removal (30%) was associated with recurrence rates below 10%. Excision without gland removal and marsupialization demonstrated higher and more variable recurrence rates, ranging from 15%–30% across cohorts. Sclerotherapy outcomes varied by agent, with recurrence rates of 3%–10% for bleomycin and over 50% for OK‐432, particularly in plunging ranulas. Most recurrences occurred within 3–6 months. Conclusion Sublingual gland excision was consistently associated with the lowest recurrence rates, while outcomes following marsupialization and sclerotherapy varied by technique and agent.
Nguyen et al. (Tue,) studied this question.