title: Midline cervical cleft: a rare congenital anomaly.
abstract: OBJECTIVE
  A midline cervical cleft (MCC) is a rare congenital anomaly due to failure of fusion of the first and second branchial arches during embryogenesis. It may present as a midline defect of the anterior neck skin with a skin projection or sinus, or as a subcutaneous fibrous cord. This report evaluates the clinical features and surgical management of an MCC.
  
  
  METHODS
  We analyzed a series of 4 patients with an MCC successfully treated at Great Ormond Street Hospital for Children in London.
  
  
  RESULTS
  Three male patients and 1 female patient between 4 and 11 months of age were found to have an MCC. Each patient presented with an erythematous, fibrous band of tissue extending between the chin and the suprasternal notch. Treatment comprised surgical excision of the lesion and Z-plasty repair. We present the embryology, common clinical presentation, investigations, differential diagnosis, and histology, along with a literature review, of this uncommon malformation of the anterior neck.
  
  
  CONCLUSIONS
  An MCC is a differential diagnosis to consider when assessing a child with a midline cervical lesion. Early surgical excision with Z-plasty repair of the soft tissue defect is the treatment of choice to prevent long-term complications.
authors.affiliation: Department of Paediatric Otolaryngology, Great Ormond Street Hospital for Children National Health Service Trust, London, England.
authors.forename: Gayathri Mandya
authors.initials: GM
authors.lastname: Renukaswamy
authors.forename: Marlene A
authors.initials: MA
authors.lastname: Soma
authors.forename: Benjamin E J
authors.initials: BE
authors.lastname: Hartley
mesh_terms: D044964:Cervicoplasty / Q000379:methods; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009333:Neck / Q000002:abnormalities* / Q000601:surgery; D012189:Retrospective Studies