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After clinical investigation, ultrasound examinations were performed in all cases. Several sonographic parameters describing the echotexture, shape and size of ranulas, their relationship to important surrounding anatomical landmarks and the characteristic spreading pattern of ERs and PRs were elaborated and evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>207 ranulas were included (82.12% ERs and 17.87% PRs). The ranulas were all in close anatomical relationship to the sublingual gland (SLG) and mylohyoid muscle (MM). The echo texture was hypoechoic to anechoic in 97.6% of the lesions. In comparison with ERs, PRs were larger and irregular in shape significantly more often (<jats:italic>P<\/jats:italic>\u2009=\u20090.0001). There were significant differences between ERs and PRs in their exact location relative to the SLG (superficial, deep, anterior, each<jats:italic>P<\/jats:italic>\u2009=\u20090.0001; posterior,<jats:italic>P<\/jats:italic>\u2009=\u20090.03) and level of the MM (above, below, above and below,<jats:italic>P<\/jats:italic>\u2009=\u20090.0001 each). The exact extent and plunging pattern were depicted in all PRs, but naturally in none of the ERs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The ultrasound criteria developed in this study, confirming previously published results, indicate that ultrasound is an excellent diagnostic tool for diagnosing ranula and differentiating between ERs and PRs.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s40477-022-00743-7","type":"journal-article","created":{"date-parts":[[2022,12,17]],"date-time":"2022-12-17T14:03:06Z","timestamp":1671285786000},"page":"487-495","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Ultrasound in the diagnosis and differential diagnosis of enoral and plunging ranula: a detailed and comparative analysis"],"prefix":"10.1007","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7838-6490","authenticated-orcid":false,"given":"Michael","family":"Koch","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Mantsopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Leibl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarina","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heinrich","family":"Iro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matti","family":"Sievert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,12,17]]},"reference":[{"issue":"10","key":"743_CR1","doi-asserted-by":"publisher","first-page":"1310","DOI":"10.1002\/hed.21326","volume":"32","author":"JD Harrison","year":"2010","unstructured":"Harrison JD (2010) Modern management and pathophysiology of ranula: literature review. 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Approval was obtained from the local institutional review board.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical statements"}},{"value":"Informed consent was obtained from all individual participants included in the study. The Authors affirm that human research participants provided informed consent for publication of all ultrasound images or videos included in this manuscript (Figs.\u00a0\u2013, Videos 1\u20133).","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}