Comparison of two alar cinch base suture in orthognathic surgery: a randomized clinical trial

Abstract

Le Fort I osteotomy is widely used in orthognathic surgery to correct maxillary deformities. However, this osteotomy may be related with the increase of alar base width. The aims of the present study were to compare two alar cinch suture after Le Fort I osteotomy and observe which type presents a better result in controlling the enlargement of the alar base after maxillary repositioning in orthognathic surgery. A randomized clinical trial was carried out with 40 patients randomly assigned in two intervention groups: group 1 - patients submitted to internal suture and group 2 - patients submitted to external suture. Of the 40 patients, 65% were female and 35% were male. The mean age of the patients was 30,25 in group I and 28,6 in group II. There was an increase in the alar base width in both groups, with significant difference between the means (P < 0,001). It was possible to compare the evolution of the means of the alar base width between group I and group II. Thus, it was observed that the external technique (group II) better controlled alar base width after Le Fort I osteotomy. It was not possible to relate the enlargement of the alar cinch with maxillary movement performed (P > 0,05). Overall, alar base cinch suture is an essential component of Le Fort osteotomies to control the alar base width. In this study, the external technique was more effective when compared to the internal technique in controlling the enlargement of the alar base width.

Latest Evidence on Orthognathic Surgery Techniques and Potential Changes in Oral Microbiota related to Intermaxillary Fixation in Orthodontic Patients: A Systematic Review

“…In addition, the nasal base enlargement of patients undergoing Le Fort I osteotomy was evaluated, and two suture techniques of the wing cinch were compared, showing an increase in the alar base width in both groups, with a significant difference between the means. It was observed that the external technique better controlled alar base width after Le Fort I osteotomy [33].…”

“…Le Fort I osteotomy is the most used surgical technique to correct maxillary deformities and, despite the good skeletal results obtained, it causes a muscular detachment of the nasal region promoting enlargement of the nasal wing base [32]. External and internal suture techniques can be used to reconstitute the nasal wing base, and in particular, recent studies have shown that the external technique appears to be more effective than the internal technique in controlling wing base widening, although future studies are needed to confirm these findings [33].…”

Cirugía de reducción de base alar: aspectos fundamentales y técnica quirúrgica

“…Una limitante importante para decidir entre las distintas técnicas es que ninguna de ellas tiene alto nivel de evidencia en cuanto a su efectividad, siendo la mayoría de los estudios encontrados de tipo descriptivo. Cabe destacar que para la cincha alar existen ensayos clínicos aleatorizados que respaldan su efectividad, pero estos son en contexto de ensanchamiento de la base nasal secundarios a osteotomías Le Fort I [30][31][32] .…”