Isolated pterygium colli in a child: case report and literature review of surgical techniques.

BACKGROUND AND

IMPORTANCE

Pterygium colli or "webbed neck" constitutes a rare congenital malformation characterized by bilateral cutaneous excess extending from the mastoid region to the acromion. Although of low incidence in the general population, this anomaly can lead to significant functional limitations and considerable psychosocial impact, particularly in children and adolescents.

CASE PRESENTATION: We report the case of an 8-year-old girl with no particular medical history, presenting bilateral cervical webbing of cutaneous appearance giving a webbed neck appearance, present since birth. Preoperative genetic screening confirmed a normal 46, XX karyotype, and clinical evaluation ruled out Noonan and Klippel-Feil syndromes. Objective measurements revealed restricted cervical rotation (45°) and lateral flexion (25°). Clinical examination revealed bilateral malformation involving exclusively the cutaneous plane, extending from the mastoid to the acromion, without associated inflammatory signs. Surgical management by bilateral excision of an ellipsoidal portion of skin with two-layer closure using unilateral advancement flaps was performed. The postoperative course was uncomplicated with discharge on postoperative Day 1.

CLINICAL DISCUSSION: Recent literature review highlights significant evolution in surgical techniques for pterygium colli. Therapeutic approaches diversify between lateral techniques and posterior approaches. Turki's classification distinguishes three morphological types guiding optimal technical choice. Severe forms may require staged surgical approach combining multiple techniques. Our 12-month follow-up demonstrates sustained outcomes, with range of motion returning to normal physiological values (rotation 80°, lateral flexion 40°).

CONCLUSION

Isolated pterygium colli in children constitutes a justified surgical indication due to its functional and aesthetic repercussions. The development of less invasive techniques and optimization of protocols allows for individualized approach, according to specific morphological characteristics of each patient.