f p s t l t s h d e s q l l w b r s g r e d t t ne of the factors that limits an informed discussion n the management of ranulas is the relative rarity ot only of this condition but salivary gland disease in eneral. For example, the incidence of salivary stones, eported as the commonest salivary condition, only ccurs in 6 cases per 100,000 population. Benign alivary gland tumors have an incidence of 8 per 00,000 and malignant salivary tumors as little as 0.7 nnually. Salivary ranulas occur much less frequently han salivary stones. In our salivary gland clinic, 570 f the 2,200 patients seen in the last 10 years had alivary stones. In this period only 11 patients preented with ranulas (2 of which were consequent to urgery for stones). The situation is compounded by he fact that mucoceles present to more than 1 surgial discipline, which further dilutes clinical experince. No one individual has enough experience to evelop new ideas and techniques that would chalenge current accepted norms. De facto the manageent of many salivary gland conditions has been froen in time. But this situation is slowly changing. A umber of centers in Europe have specialized in surical management of salivary gland disease. In these enters patients presenting with salivary stones in the iddle or posterior duct have greater than a 75% hance of stone clearance and only 2% of cases subequently undergo gland excision. Despite these dvances a consensus on the appropriate manageent of ranulas has not evolved. Over time, however, spects of this condition have been clarified. It would seem the vast majority of ranulas are exravasation cysts (approximately 90%). This fact has mportant clinical applications because it means that he connective tissue capsule of the cyst need not be emoved at the time of surgery. This is not particularly mportant in small lesions but in plunging ranulas it eans that wide exposure through both the mouth