Comparative analysis of the nasal effects of two alar cinch suture techniques in LeFort I osteotomy. A retrospective longitudinal study

TL;DR

This study compares two nasal suture techniques used in orthognathic surgery and finds that one affects nasal width more significantly than the other.

Contribution

The study provides empirical evidence on the differential effects of two alar cinch suture techniques on nasal morphology after LeFort I osteotomy.

Findings

A greater increase in interalar width was observed in the group using the anterior nasal spine-passing suture.

Nasal projection and nasolabial angle changes were not influenced by the suture technique used.

Orthognathic surgery significantly alters nasal morphology, particularly interalar width.

Abstract

The purpose of this study was to compare postoperative nasal morphological changes between two intraoral alar cinch suture techniques in patients undergoing Le Fort I osteotomy.

A retrospective longitudinal study was conducted with patients undergoing Le Fort I osteotomy, and two types of alar cinch were evaluated. Patients with a history of nasal procedures or cleft lip surgery were excluded. Group 1 received a cinch that passes through the anterior nasal spine, and Group 2 involves only soft tissues. A descriptive analysis was performed, and the normality of variables was assessed using the Shapiro–Wilk test. The repeated measures ANOVA test was then used to evaluate changes over time between the two groups. When the assumption of sphericity was violated, the Mauchly’s test, Greenhouse–Geisser, Huynh–Feldt, and Lower-Bound tests were used to correct for it. Between- and within-subjects effects were analyzed using Type III sums of squares. A significance level of 0.05 was considered.

(N = 60) were randomly assigned to two groups (n = 30). No significant differences were found in demographic or clinical variables at baseline (p > 0.05). A considerable increase in interalar width was seen before and after surgery (p < 0.001), with more significant differences in group 1 (p = 0.004). Nasal projection and nasolabial angle changed between pre- and postoperative periods (p < 0.001 and p = 0.003, respectively); however, there was no difference in the type of suture technique used (p = 0.474 and p = 0.647).

Orthognathic surgery produces significant changes in nasal morphology. However, only the interalar width showed differences between sling techniques, with a greater increase in the group using the sling that passes through the anterior nasal spine. These findings indicate that the choice of sling affects control of the nasal base, while projection and the nasolabial angle depend on maxillary movement.

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