Mehri Turki Surgical Technique of the Webbed Neck

June 6, 2024 updated by: Imen Turki Mehri, MD, Mohamed Tahar Maamouri University Hospital

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

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.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

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.

Study Type

Interventional

Enrollment (Actual)

5

Phase

  • Not Applicable

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • webbed neck with abnormal hairline

Exclusion Criteria:

  • Surgical contraindication for any health concern
  • Puberty age

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Other: Single arm interventionnal study
A lateral approach surgical technique for the treatment of the webbed neck.
Procedure: Mehri Turki Surgical Technique of the Webbed Neck
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

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
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
Just at the postoperative outcome up to 24 months of follow-up
Posterior hairline placement
Time Frame: Just at the postoperative outcome up to 24 months of follow-up
Number of patients with posterior hairline assent
Just at the postoperative outcome up to 24 months of follow-up
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
Just at the postoperative outcome up to 24 months of follow-up

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Recurrece of the fold
Time Frame: 24 months
Number of patients in whom the fold of the neck recurred
24 months
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
from 8 months up to 24 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Mohamed Tahar Maamouri University Hospital

Investigators

  • Principal Investigator: Imen Mehri Turki, University Hospital Mohamed Tahar Maamouri. Nabeul, Tunisia

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 27, 2008

Primary Completion (Actual)

November 22, 2015

Study Completion (Actual)

January 24, 2017

Study Registration Dates

First Submitted

May 24, 2024

First Submitted That Met QC Criteria

June 1, 2024

First Posted (Actual)

June 6, 2024

Study Record Updates

Last Update Posted (Actual)

June 7, 2024

Last Update Submitted That Met QC Criteria

June 6, 2024

Last Verified

June 1, 2024

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • Hospital MT Maamouri

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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