Midline cervical cleft –⁠ a series of four case reports

Overview

Congenital midline cervical cleft is a rare congenital malformation of the midline neck that may be overlooked or misdiagnosed at birth because of its low incidence and limited clinical experience with this condition. The aim of this case series was to describe the clinical presentation, diagnosis, surgical treatment, and short-term outcomes in four pediatric patients. We retrospectively evaluated four patients treated at the Department of Otorhinolaryngology, Second Faculty of Medicine, Charles University and Motol University Hospital, between 2024 and 2026. In all patients, the characteristic clinical findings were present to varying degrees and included a cutaneous defect in the midline of the neck, a fibrous cord, a cranial skin projection, and a caudal sinus with mucinous secretion. All patients underwent surgical excision; in three patients, closure was performed using double Z-plasty, and in one patient, multiple Z-plasty was used. The postoperative course was without serious complications, and follow-up revealed neither recurrence nor functionally significant limitation of neck motility. Congenital midline cervical cleft has a characteristic clinical presentation, and awareness of this condition is essential for early diagnosis. Early surgical treatment with reconstruction using Z-plasty helps prevent functional and cosmetic complications.

Keywords:

midline cervical cleft – congenital neck anomalies – Z-plasty