Double-opposing Z-plasty for correction of midline cervical web

Midline cervical web is a rare congenital anomaly that may be associated with a spectrum of midline developmental anomalies of the neck, lower face, and mandible. The clinical hallmark is a fibrous band typically extending from the symphysis of the mandible to the suprasternal notch. Various techniques have been used for surgical correction and generally have involved excision either with a straight-line closure or the incorporation of a Z-plasty. The Z-plasty method usually has included only skin and subcutaneous fat, but the development and transposition of composite skin-platysma flaps has been used. The authors describe the correction of a midline cervical web designed with double-opposing Z-plasties of skin and subcutaneous fat and platysma muscle mobilized and transposed separately. This technique provides two primary benefits: creation of a well-defined cervicomental angle, and correction of the vertical soft tissue deficiency in the anterior neck.