Pterygium colli medianum and midline cervical cleft: midline anomalies in the sense of a developmental field defect.

We report on 2 patients (and review a third) with a vertical midline neck web which extends from the lower symphysis of the mandible to a variable extent down to the jugular notch. This uncommon congenital anomaly, previously reported primarily in the (plastic) surgery literature, is interpreted as the mildest form and most dorsal extension of anterior midline cleft defects which include the supraumbilical raphé and cleft sternum with or without congenital hemangiomata. By analogy with the former, and the fact that in a boy with a severe cervical midline web there was a cleft of the upper sternum, we interpret this neck-web as a developmental field defect. It is a sporadic anomaly but may be associated with other midline malformations including congenital heart defect(s). Thus, finding such a web at birth should prompt a careful search for other anomalies.