Midline cervical cleft

During the past 2 years, five cases of midline cervical cleft were treated at the Children's Memorial Hospital Otolaryngology Department. There were four white girls and one boy; their ages ranged from 16 days to 5 months. All cases had been evaluated previously by primary care physicians and were misdiagnosed as thyroglossal duct cysts. The defects representing a cleft deformity were located on the midline of the anterior neck and were vertically oriented. The dimensions of the lesions approximated 2 x 1/2 cm, and they were associated with an underlying fibrous cord that varied in prominence. All patients were treated surgically, by elliptical excision and removal of the underlying cord. If the adjacent tissues were lax and no anterior cervical contracture was present, the wound was closed primarily. This was accomplished in all patients except one in which Z-plasty was necessary to correct a contracture. All patients who underwent primary closure achieved good cosmetic results and did not develop secondary contracture. The patients' recovery and subsequent courses were uneventful.