Midline Cervical Cleft Excision of Fibrous Cord – Z Plasty Closure

Excision and Z-Plasty Closure of Midline Cervical Cleft

Presence of the lesion

Where the skin and cutaneous circulation is compromised in such a manner that a transpositional flap (z-plasty) can not be performed

Standard soft tissue neck instrumentation including: 15 blade scalpel, hemostats, fine dissecting scissors (Metzenbaum, Tenotomy), monopolar and/or bipolar cautery, soft tissue forceps, needle driver, suture (4-0 vicryl for deep dermal, 4-0 or 5-0 monocryl for subcuticular), skin glue

standard soft tissue neck set up with neck extension

physical examination with attention to neck range of motion, mandibular clefting/hypoplasia; no specialized imaging required

The deformity is the cutaneous defect and abnormal cutaneous tissue and the associated fibrous cord which extends from the sternum to the mentum of the mandible which causes anterior contracture

Incomplete excision of the fibrous cord can result in wound contracture and failure to achieve surgical goals; lack of execution of Z-plasty can result in inadvertent neck contracture or sub-optimal scar appearance, seroma, infection or hematoma

None

Int J Pediatr Otorhinolaryngol
. 2019 Dec;127:109657. doi: 10.1016/j.ijporl.2019.109657. Epub 2019 Aug 23.