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NCT Number: NCT06446791

Mehri Turki Surgical Technique of the Webbed Neck

The webbed neck is one of the conspicuous deformities of Turner syndrome that presents a surgical challenge. Despite the availability of surgical techniques, surgical outcomes are not always acceptable and recurrence occurs. Mehri Turki performed a surgical technique based on a latéral cervical approach allowing direct visual control to manage the fibrotic band. It provides a high level of visual control so that vulnerable anatomic structures are easily protected.

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Key information

Conditions

Congenital Webbing of Neck Cardiovascular Abnormalities Cardiovascular Diseases Chromosome Disorders Congenital Abnormalities Congenital, Hereditary, and Neonatal Diseases and Abnormalities Disorders of Sex Development Endocrine System Diseases Female Urogenital Diseases Female Urogenital Diseases and Pregnancy Complications Genetic Diseases, Inborn Gonadal Disorders Gonadal Dysgenesis Heart Defects, Congenital Heart Diseases Male Urogenital Diseases Nuchal bleb, familial Sex Chromosome Disorders Sex Chromosome Disorders of Sex Development Turner Syndrome Urogenital Abnormalities Urogenital Diseases

Age range

17 year–19 year

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

About this study

Five girls between 17 and 19 years old, with Turner syndrome, had a webbed neck (pterygium colli) with low and laterally displaced nuchal hairline. The surgical technique aims to correct neck contour and hairline placement while concealing cervical scars. Thus, Preoperative drawing delimitated the harmful triangular hairy skin next to the fibrous band extending from the mastoid to the acromion. Besides, the predefined design drawings provide the exact placement of the future hairline. Choosing a prone position for bilateral and symmetrical repair, the surgical technique was as follows:

The incision was made at the junction of the hairless skin and the hairy skin from the mastoid up to the lower end of the webbing skin, in front of the acromion and completed by Z plasty to avoid scar contracture. The subcutaneous skin was undermined in the anterolateral direction, exposing the fibrous fascial band which must be excised to prevent recurrence. the harmful skin having a triangular shape was excised considering the future hairline. Skin closure was done after the superior traction of the posterior cervical advancement.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • webbed neck with abnormal hairline

Exclusion criteria

  • Surgical contraindication for any health concern
  • Puberty age

Treatment and study plan

Mehri Turki Surgical Technique of the Webbed Neck

Procedure

The incision was made at the junction of the hairless skin and the hairy skin from the mastoid up to the acromion. A subcutaneous undermining allows direct visual control to excise the fibrotic band. Then the hairy skin with a triangular shape was excised. The closure of the defect was done after undermining an anterior cervical flap which was translated in a posterosuperior direction. Z plasty was performed in front of the acromion to prevent scar contracture. Surgical scars are concealed in the hairline which was well placed. The same procedure is done at the same surgical field on the other side to achieve perfect symmetry.

Other names: Mehri Turki Lateral approach Technique for the webbed beck

Primary outcomes

  1. Neck contour

    Time frame: Just at the postoperative outcome up to 24 months of follow-up

    Number of patient obtaining a normal neck contour without lateral fold

  2. Posterior hairline placement

    Time frame: Just at the postoperative outcome up to 24 months of follow-up

    Number of patients with posterior hairline assent

  3. Scars placement

    Time frame: Just at the postoperative outcome up to 24 months of follow-up

    Number of patients with a placement of scars at the level of the hairline

Secondary outcomes

  1. Scars quality

    Time frame: from 8 months up to 24 months

    Scars evaluation according to Vancoover scare scale (VSS) for all patients The quality of post-operative scar was evaluated according to VSS as follows: combinations of 4 criteria (1) height (Normal/ 0; 0-2mm/ 1; 2-5mm/ 2 ; > 5mm / 3) and (2) pliability (Normal 0/ Supple 1/ Yielding 2/ Firm :3 Banding/4, Contracture/5); (3) Pigmentation (Normal : 0/ Hypopigmentation/ 1 Hyperpigmentation/ 2), and (4) Vascularity (Normal/0 Pink/ 1 Red/ 2 Purple/3).

    scars quality was judged as follows : Excellent result VSS <1 / Acceptable 1< VSS <5 ; Poor scar >5

  2. Recurrece of the fold

    Time frame: 24 months

    Number of patients in whom the fold of the neck recurred

Sponsors and collaborators

Lead sponsor

Mohamed Tahar Maamouri University Hospital

Other

Registry information

Official study title

The Lateral Approach of the Webbed Neck: Mehri Turki Surgical Technique

Important dates

Study start
2008
Primary completion
2015
Study completion
2017
First posted
Jun 6, 2024
Registry last updated
Jun 7, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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