Comparison of two techniques of cinch suturing to avoid widening of the base of the nose after Le Fort I osteotomy.

All Le Fort I osteotomies have the potential to alter the dimensions of the alar base, and widen it. Surgical techniques to control this lateralisation of the base of the nose, including those of cinch suturing of the alar base, have been widely described and modified. We have compared two techniques of cinch suturing to try and prevent widening of the base of the nose after Le Fort I osteotomy. We studied 40 patients with skeletal class III facial deformities treated by orthognathic operations by the same surgeon. They were randomly divided into two groups of 20 each, one of which was treated with a classic cinch suture and the other by a modified technique. The distances between the nasofacial skinfold at the left alar bases, the columella, and the right nasofacial skinfold were recorded before and six months after operation. The results of the modified technique were more stable than those after classic suturing. In only 3/20 patients in the classic group did the suture prevent nasal widening, whereas in the modified group the number was 14/20.