Webbed neck skin#
Webbed neck free#

Webbed neck skin#

To avoid visible scars, Shearin and Defranzo used a posterior butterfly incision in which the loose skin and subcutaneous tissue was pulled to a midpoint on the back of the neck. Through a midline incision in T, two lateral flaps are detached and then translated into a posterior-superior direction to erase cervical webbing. įoucar (1948) described a posterior approach. However, the skin of the anterior basicervical region becomes hairy by the transposition of the posterior skin of the pterygium colli. Ĭhandler in 1937 was the first to describe the surgical correction of pterygium colli using Z-plasties. The aim of the surgical treatment is to create a normal neck contour with a symmetrical postero-lateral hairline by excising a triangular cutaneous band as done in our patients. Girls with Turner syndrome present a hairy posterior face of the pterygium colli continued by a low hairline next to the sixth and seventh cervical vertebrae. Von Kaisenberg revealed the hypoplasia of lymph vessels in the superficial dermis by using immunohistochemical markers. This hygroma is secondary to lymphatic malformation, particularly dilated jugular lymphatic sacs that result from a blockage in the venous drainage system.

Some authors attribute it to the spontaneous resolution of a cervical cystic hygroma before 16 weeks gestation. The etiopathogeny of this deformity is discussed.

The excess of the skin is associated with a thickening of the superficial cervical fascia sometimes entangled by fibers of the platysma muscle. It extends from the mastoid to the acromion. It corresponds to bilateral dermal webbing that can be identified and rolled between the fingers. The first description of the webbed neck was reported by Kobylinski in 1883 and the name “pterygium colli” was coined by Funke in 1902. In addition, the morphological appearance of the neck and the placement of the hairline were correct allowing these girls a better social integration (Figure 3, Figure 4 ).

Webbed neck free#

No functional deficit was found and the range of motion of the head and shoulders was completely free in all these girls. The hyperthrophic scars observed in three patients were treated by corticotherapy injection and silicone sheet application. The follow-up was done with an average of 24 months. Skin closure was done after postero-superior translation of the lateral cervical flap associated to a single Z-plasty on the ending of the incision regarding to the acromion (Figure 2 ). Obtaining the hedged cutaneous surface, the harmful skin having a triangular shape was excised with respect to the future hairline. An undermining of the subcutaneous skin was done on the antero-lateral direction exposing the fibrous fascial band which must be excised to prevent recurrence. The incision was made at the junction of the hairless skin and the hairy skin from the mastoid until the lower ending of the webbing skin. The girl was placed in a prone position for bilateral repair (Figure 1 ). They underwent it under general anesthesia. For all these girls, the surgical method was the same. Webbed neck deformity, Turner syndrome, surgical technique, pterygium colliįive girls between 17 and 19 years old came for surgical correction of their pterygium colli with low and laterally displaced nuchal hairline. The presence of a multidisciplinary team, formed with maxillofacial and plastic surgeons, endocrinologists and psychologists, is required to treat these patients allowing reintegration into society and family. Three patients developed hypertrophic scars.Ĭonclusion: The lateral approach associated with an advanced flap and a Z-plasty is an effective technique for correction of this neck deformity. No recurrence was observed through 24 months.

Results: No postoperative wound infection occurred. Methods: Through five clinical cases, we describe the surgical technique with a lateral approach which provides a better control of the operative site, allows for the excision of the underlying trapezial fascial web, thus preventing recurrence seen in the posterior approach, and restores a normal hairline. We reviewed our experience with the surgical correction of the pterygium colli. Various but rare surgical approaches have been described to correct this deformity.

Objective: The webbed neck deformity or pterygium colli is the number one symptom of the Turner syndrome that leads the patient to consult a doctor.