Diagnosis In-depth

Simple palpation of the swelling under the neck or under the tongue is often all that is necessary to make the presumptive diagnosis of salivary mucocele. These swellings are soft and feel like fluid within a pocket of tissue. This is unlike the feel of a tumor that might cause a similar swelling in these areas. Tumors usually have a firm, often irregular, feel to them and may be painful to touch.

The definitive diagnosis is made by removal of a sample of the fluid from the swelling and examining it under the microscope. The fluid from a mucocele is usually clear or slightly yellow and thick like mucus. There are usually few cells seen in the sample. Special stains are used to determine if the fluid is saliva. It is important to make sure that the problem is not a pocket of infection (abscess) that might require different treatment.

No other tests are usually necessary to make the diagnosis.

Treatment In-depth

Some veterinarians attempt to treat salivary mucocele with periodic drainage by lancing the swelling and placing a rubber drain within the pocket. This may work in the lucky patient, but for most, the newly created hole quickly seals over after the drain is removed and the swelling occurs again.

The most reliable treatment for these conditions is by surgery.

Ranulas and pharyngeal mucoceles are treated by "marsupialization." This the conversion of a closed cavity into an open pouch, in this case forming a permanent large opening from the mucocele into the oral cavity. This is accomplished by suturing the walls of the mucocele to the surface of the under portion of the tongue or back of the mouth. It allows any further leakage of saliva to drain directly into the mouth without creating a swelling. In most cases, as the swelling reduces in size, so does the size of the permanent opening.

Cervical mucoceles are best treated by removal of the entire mandibular salivary gland and its duct. The duct travels from the gland under the base of the ear to an opening under the tongue along with the sublingual salivary gland, which is removed along with the mandibular gland and duct during this procedure. This is done through an incision behind the corner of the jaw. In animals with very large swellings under the neck, it can be difficult to determine which side is the source of the problem. If it cannot be determined which side is the cause, both sides can be removed without long-term problems for the animal.

Antibiotics are often given to these animals whether an infection is present or not, although they may not be necessary at all. The swelling under the skin or inside of the mouth can be a source for infection, but infection is not a frequent occurrence with these problems.