Lip Swelling and Mucocele Excision

Why is there a swelling in my child’s inner lip or mouth?

A swelling in a child’s inner lip or oral cavity is commonly a mucocele. Other causes include a malformation, a dermoid cyst or rarely a tumor. In the history, it is important to note the onset, frequency, duration of the swelling and other symptoms such as pain or bleeding to aid the diagnosis. The swelling should be evaluated by a paediatric surgeon or dentist.

What is a mucocele or mucous cyst?

A mucocele is a swelling commonly found at the inner lower lip of the mouth. It is a collection of mucous due to trauma or obstruction to the minor salivary or sublingual duct. It is not cancerous. It can also involve the floor of the mouth, with resultant extension into the neck. This is called a “plunging Ranula.”

When should I excise a lip mucocele?

With repeated trauma or worsening obstruction, the swelling grows bigger and may ulcerate, causing pain and bleeding. When symptoms persist, treatment is available for example, excision, marsupialization or repeated steroid injections. Excision is preferred to completely remove the involved minor salivary gland and duct(s). If there is misaligned teeth that cause biting on the lip, a referral may be made to a dentist for correction

How is the excision of a lip mucocele performed in a child?

Local and general anaesthesia may be required to ensure a smooth operation in a young, less cooperative child. The swelling is incised and the minor salivary or sublingual gland is removed in completeness. The wound is then washed and closed with absorbable stitches. This is performed as a day surgery.

How is the recovery post excision?

Your child can go home on the same day after surgery. Soft diet for example, porridge or oats is started for 1 week to prevent trauma and bleeding to the wound. An oral mouth wash is also helpful to keep the wound clean in cooperative children. Oral Antibiotics, if prescribed, should be completed. If there are signs of infection, for example pain, swelling, pus discharge, redness, treatment is available and medical advice should be sought early.

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