Midline Cervical Cleft: Review of an Uncommon Entity

Abstract

Introduction. Midline cervical cleft is a rare congenital malformation which nonetheless has a classic presentation. This study presents one of the largest single series of new patients with MCC and provides an exhaustive review and catalogue of publications from the international literature. Materials and Methods. Retrospective chart review performed in two academic medical centers and literature review performed with primary verification of all quoted references. Results. Ten patients with MCC were identified (8 boys and 2 girls). All patients presented with the classic findings of this congenital anomaly, and the length of the skin defect correlated with an increase in the patient's age. Surgical excision was complete in all cases. Thorough international literature review yielded only 195 verifiable previously reported cases. Conclusions. This is one of the largest series of new patients with midline cervical cleft presented in the world literature. Although rare (with less than 200 cases published to date) this entity does have a reliable presentation that should lead to rapid and accurate diagnosis. Complete surgical excision at an early age is appropriate since the anomaly increases in length commensurate with the patient's age.

Congenital Midline Cervical Cleft and W-Plasty: Our Experience

“…The lesion is situated in the midline between the chin and suprasternal area, with variable length and width. Puscas [14] found a positive correlation between the size of the defect and the patient's age.…”

“…Several studies suggested that there is a predominance of CMCC in the Caucasian population, mainly in females, with a F:M ratio of 2:1 [15, 16]. However, Achard et al in 2016 [17] found an equal ratio between males and females with CMCC, and Puscas [14] even found a male predominance, with 8 boys and 2 girls, in his published retrospective series in 2015. Consistent with most studies, we identified 13 females and 8 males with a CMCC (a ratio of 1.6:1), with most of them being Caucasian (Table 1).…”

Midline anterior neck inclusion cyst: A novel superficial congenital developmental anomaly of the neck

“…Furthermore, although the location may be similar, thyroglossal duct cysts present as subcutaneous cystic neck masses without overlying skin change, readily distinguishing this entity from MANICs . In contrast, midline cervical clefts have evident overlying skin changes with a distinctive linear patch of atrophic skin with a skin tag at the superior aspect . Bronchogenic cysts can also occur in the suprasternal notch region, although these are slightly more inferiorly located .…”

Congenital Papule on the Anterior Neck

“…Our patient's lesion resembled a congenital midline cleft. Congenital midline clefts are characterized by a superior skin tag with an inferior blind sinus .…”