Clinical Outcomes of Polidocanol Foam Sclerotherapy in Treatment of Sublingual Ranula

Introduction and Aims: Ranula is a mucus retention cyst originating from the sublingual gland, and surgical intervention has traditionally been the main treatment. However, surgery is often associated with recurrence, risk of nerve injury, and patient discomfort. Sclerotherapy using polidocanol, a low-toxicity agent, has emerged as a promising minimally invasive alternative. This study aimed to evaluate the clinical outcomes and safety of polidocanol injection therapy in patients with sublingual ranula. Methods: This retrospective study included 34 patients with sublingual ranula who underwent intralesional injection of 3% polidocanol between December 2021 and March 2025. Some patients with large or recurrent lesions were additionally treated with pingyangmycin. Clinical data including age, sex, lesion size, symptom duration, number of injections, and follow-up time were collected. Treatment outcomes were categorized as complete resolution or unfavorable outcomes (including partial remission or recurrence). Statistical analyses were performed to identify factors associated with treatment outcomes. Results: Among the 34 patients, 30 (88.2%) achieved complete resolution, while 4 (11.8%) had unfavorable outcomes. Maximum lesion diameter was independently associated with treatment outcome (adjusted OR per 1-mm increase = 0.886, 95% CI: 0.742-0.982; P = .018; Firth-penalized logistic regression adjusted for age and lesion site). No serious complications were observed during a mean follow-up of 22.44 ± 14.93 months. Conclusion: Polidocanol injection therapy appears to be a safe and minimally invasive option for the management of sublingual ranula, demonstrating favorable clinical outcomes and a high rate of lesion resolution in this retrospective cohort. Clinical Relevance: Polidocanol sclerotherapy offers a conservative outpatient treatment option for sublingual ranula, providing favorable clinical outcomes with low morbidity and potentially reducing the need for surgical excision.