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Midline Cervical Cleft: An Anatomical Finding and a Proposal for a New Approach
Mireia Riba1, Miguel Bejarano1, Carlos Hernández1,2
1Department of Pediatric Surgery, 16512Hospital Sant Joan de Déu, University of Barcelona, Spain.
Summary
Congenital midline cervical cleft is a rare neck malformation. A newly identified contractile muscle band anterior to the platysma causes neck retraction and is key to preventing relapse after surgery.
Area of Science:
- Medicine
- Surgery
- Anatomy
Background:
- Congenital midline cervical cleft is a rare congenital anomaly.
- It typically presents with hypotrophic skin, a cranial nipple-like structure, and a caudal blind sinus.
- Limited cervical extension and common relapse after z-plasty are characteristic.
Purpose of the Study:
- To describe radiological, surgical, and histological findings of 4 treated cases.
- To identify the cause of neck retraction and surgical relapse.
- To introduce a previously undescribed contractile structure responsible for neck retraction.
Main Methods:
- Retrospective review of 4 cases over 8 years.
- Analysis of radiological, surgical, and histological data.
- Identification and characterization of anatomical structures.
Main Results:
- Four cases of congenital midline cervical cleft were treated.
- A distinct contractile structure, a striated muscle band anterior to the platysma, was identified.
- This muscular band was found to be responsible for neck retraction and tension.
Conclusions:
- The newly identified muscle band is crucial in congenital midline cervical cleft.
- Surgical release of this muscle band is essential for preventing relapse.
- This finding offers new insights into the surgical management of this rare condition.