BENIGN NEOPLASMS OF THE MOUTH 103 



containing cartilage and sometimes spicula of bone. They 

 have their origin in the submucous tissue or the periosteum 

 of the bone, and usually occur as a single growth. 



Symptoms. —The tumor is found growing at the edge of the 

 gums in the form of a hard, reddish enlargement varying 

 in size from a pea to a walnut. Its growth is slow often 

 requiring months to develop into sufficient size to be notice- 

 able. The slow growth and firm consistency assist in dis- 

 tinguishing it from any of the malignant growths. 



Treatment.— Complete extirpation and cauterization of the 

 wound with silver nitrate or thermocautery are curative. 



Osteoma. —These tumors are found growing from the peri- 

 osteum of the maxillae. They are composed of osseous mate- 

 rial and frequently develop after injuries to the periosteum. 



Symptoms.— Osteomas appear as very hard enlargements 

 firmly attached at their base. As a rule the skin or mucous 

 membrane is not adherent over them. Their hardness and 

 slow growth readily distinguish them from malignant tumors. 



Treatment.— Expose the enlargement by an incision through 

 the soft tissues and dissect down to the base, when it may 

 be removed if not too diffuse, by the use of bone forceps or a 

 small bone chisel. Curette the surface until smooth and 

 suture the skin over it. After-treatment as an ordinary 

 wound, using antiseptics to cleanse it daily. 



Retention Cysts.— Ranvla.— These are enlargements ap- 

 pearing in the buccal cavity from a stoppage of the ducts of 

 glands which discharge their secretions into the mouth. Co- 

 hesion of openings occurs from inflammations of the mucous 

 membrane, swelling, etc., partially or completely closing the 

 duct. At the same time the glands continue to secrete their 

 fluids which distend the ducts forming the enlargements. 

 Closure or obstruction of Wharton's duct produces an exten- 

 sive enlargement under the tongue. The most common 

 retention cysts, however, are from the ducts of the buccal 

 or sublingual glands. When the obstruction is complete 

 the secretions, as they collect, burrow downward along the 

 neck producing an enlargement which appears subcutane- 

 ously in the submaxillary region, or may extend to the supe- 



