Central cervical cleft: A very rare case of cervical congenital malformation

Abstract

Central cervical cleft is an rare congenital midline anomaly of the neck, typically presenting as a vertically oriented skin defect accompanied by a subcutaneous fibrous band and, in many cases, an associated skin tag. This case report presents a case involving a five-year-old female who exhibited a midline cervical lesion with intermittent clear discharge but no associated pain or functional impairment. Clinical examination identified a characteristic cutaneous defect with a prominent skin tag in the midline of the anterior neck. Radiological evaluation, including ultrasound and CT scan, confirmed the localized nature of the anomaly and excluded deeper structural involvement. After appropriate counseling and reassurance of the benign nature of the lesion, surgical management was undertaken under general anesthesia. The excision was followed by multilayered wound closure incorporating multiple Z-plasty incisions to optimize healing and minimize scar formation. The postoperative course was uneventful, and the cosmetic outcome was further enhanced through regular follow-up and scar management using silicone gel. This case highlights the importance of early recognition and surgical correction of central cervical cleft to prevent potential functional limitations and achieve superior aesthetic results. Z-plasty remains a valuable reconstructive technique in such congenital neck anomalies, particularly in pediatric patients.