Simple ranulas in the floor of the mouth usually reflect a mucus escape reaction that develops after disruption of sublingual gland elements. As such, they comprise an accumulation of mucus within connective tissue and lack an epithelial lining. Simple ranulas should be distinguished from cervical, or plunging, ranulas. Recommended treatments for simple ranulas usually involve excision of the ipsilateral sublingual gland, "marsupialization," or simple excision of the cyst. Alternatively, the ranula can be treated with the placement of a silk suture or seton into the dome of the cyst. Four cases using this technique are reported.