Double opposing Z-plasty for congenital midline cervical web: A case report

Congenital midline cervical clefts (CMCCs), rare congenital anomalies of the cervical neck, are unaesthetic and can lead to secondary deformities of the mandible. Repair usually involves excision of the lesion followed by primary closure, W-plasty, or Z-plasty. We repaired a CMCC in a 4-year-old girl using double opposing Z-plasty of the subcutaneous tissues and platysma to increase the vertical length of the skin and form a deeper cervicomental angle. The surgery substantially improved appearance and function, producing a sharper cervicomental angle and reduction in cleft chin. Scarring was minimized with postsurgical treatments. However, because of the patient's age, an open-bite deformity remained. Therefore, we recommend surgical correction for CMCC in the first year of life.