You have gained maximum
CME credits this year.
Your CME credits will reset next year. You can still continue to watch our videos.
Z-plasty allows broken-line closure, reorientation of the defect in the horizontal plane with re-creation of a cervicomental angle, and most importantly, a lengthening of the anterior neck skin that aids in preventing recurrent contracture. We present our experience managing a congenital cervical midline cleft in a 3-month-old patient and describe a simple technique for planning the ideal Z-plasty closure. No simple description for planning the ideal closure for this defect could be found in the otolaryngology literature.
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.
Be the first to review this video.
Reviews require sign-in. Sign in to write one.
Have a question about this case? Send a note to Dr. Inbal Hazkani — they'll reply by email.
This is approved for 0.5 AMA PRA Category 1 Credit™ via CineMed (ACCME / ACPE / ANCC). The two viewing modes are different — pick what fits your time.
"*" indicates required fields