International Journal of Oral and Maxillofacial Surgery
Clinical PaperCraniofacial AnomaliesFacial morphology and growth following surgery for congenital midline cervical cleft patients
Section snippets
Case series
All cases of CMCC treated at the Royal Children’s Hospital in Melbourne, Australia over a 10-year period were reviewed. The diagnosis was made clinically based on the presence of classic features of CMCC: a superior nipple-like skin tag and a reddened strip of atrophic skin occurring at any level between the chin and the sternal notch, with a sinus tract at the caudal end. A typical clinical case is shown in Fig. 1.
Image acquisition
Children were routinely photographed prior to surgery and at follow-up
Results
Six patients with a midline cervical cleft underwent surgical treatment between 2006 and 2016. None of the patients had any other associated major congenital anomalies. A clinical photograph was used to illustrate the ‘tethering effect’ of the lesion to the mandible (Fig. 2). In all cases, the patient underwent attempted complete excision of all of the pathological tissue, including the attenuated skin and the fibrous bands beneath the surface. All surgical procedures were performed by one
Discussion
Congenital midline cervical cleft (CMCC) is a rare congenital anomaly1, 16, 17. Most clinicians are likely to see only one or two cases in a lifetime, and so empirical clinical trial data are difficult to collect. Therefore, treatment planning must be based on limited empirical evidence. In this study, dense morphometric techniques were used to assess facial growth following the surgical removal of the pathological band connecting the neck structures to the mandible. It was found that anterior
Funding
None.
Competing interests
None.
Ethical approval
Approval for the study was obtained from the Human Research Ethics Committee of the Royal Children’s Hospital (36114A).
Patient consent
Written patient consent was obtained to publish the clinical photographs.
Acknowledgements
The authors would like to thank all of the patients and their parents who participated in this study.
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