By Gary M. White, MD

The midline cervical cleft (MCC) is thought to be a developmental defect secondary to failure of the 1st and 2nd branchial arches to fuse in the midline during the 3rd and 4th weeks of gestation.


A congenital linear, vertical, atrophic lesion on the anterior midline of the neck is characteristic. A nipple-like tag may be present at the cranial end and a fistula or sinus at the causal end with atrophic skin in between. A fibrous thickening connects the lesion to the platysma. Contracture of the neck and jaw may occur.


Complete surgical excision in infancy is recommended using a Z-plasty technique to prevent contracture and an unaesthetic scar.


Indian J Otolaryngol Head Neck Surg. 2013 Dec; 65(4): 367–370

Arch Plast Surg. Jul 2014; 41(4): 429–431


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