Öz
Objective
The purpose of this study was to evaluate the effect of cinch suture to prevent enlargement in the nasal tissue of 15 patients who
maxillary advancement and impaction surgery with Lefort I osteotomy.
Material and methods
This study 15 orthognathic surgery patients (9 female, 6 male) underwent maxillary advancement and impaction surgery with
Lefort I were included. While the average amount of advancement of the upper jaw is 5±1.55 mm; impaction amount is 2.5±0.83
mm. The patients were seperated into two groups, cinch suture performed (cinch suture group) and cinch suture not performed
(control group). Before the operation the width lateral point of nose wings alar wideness (AW) and the joint that nose wings
with face on base inferior subalar wideness (SAW) was assigned. Nasolabial angle (NLA) was determined on cephalometric
radiographs taken before and after surgery. The mean follow-up period of the study was 7.2±0.8 months. All datas from this
study was analized by ‘Statistical Packages for the Social Science’ statistical programme.
Results
After orthognatic surgery a significant increased on AW point observed on both group the cinch sütüre performed and the control
group. While the difference between the groups in AG was not significant (p=0.463), the difference between the groups in SAG
was significant (p=0.047). NLA measurements after orthognathic surgery decreased in the cinch suture group (p=0.182) and
increased in the control group (p=0.865).
Conclusion
Despite cinch suture increased observed on both AW and SAW point after Lefort 1 osteotomy. We can say that while cinch suture
finded beneficial to contain the enlargement of SAW, finded insufficient for prevention of enlargement AW. In our study, no
significant effect of cinch suture on NLA was found. In contrast to cinch suture the risk of enlargement nasal wings should be
considered and the patient should be informed before the operation.
Anahtar Kelimeler
Kaynakça
- 1. Betts NJ, Edwards SP. Soft Tissue Changes Associated with Orthognathic Surgery. Milaro M. editor. Peterson’s Principles of Oral and Maxillofacial Surgery; 2nd ed. Vol.2. Ontario, Canada: BC Decker Inc, 2004. Chapter 59.
- 2. Ryan FS, Barnard M, Cunningham SJ. What are orthognathic patients’ expectations of treatment outcome—a qualitative study. J Oral Maxillofac Surg. 2012;70:2648-55.
- 3. Mani V, Panicker P, Shenoy A, George AL, Chacko T. Evaluation of Changes in the Alar Base Width Following Lefort 1 and AMO with Conventional Alar Cinch Suturing: A Photographic Study of 100 Cases. J Maxillofac Oral Surg. 2020;19(1):21-5.
- 4. Liu X, Zhu S, Hu J. Modified versus classic alar base sutures after LeFort I osteotomy: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014 Jan;117(1):37-44
- 5. Bell WH, Proffit W. Esthetic effects of maxillary osteotomy. In: Bell WH, White RP, editors. Surgical correction of dentofacial deformities. Philadelphia: WB Saunder 1980 Tamer Y. et al. Page 91 p. 368–70.
- 6. Cunningham SJ, Hunt NP, Feinmann C. Psychological aspects of orthognathic surgery: a review of the literature. Int J Adult Orthodon Orthognath Surg. 1995;10(3):159-72. 7. Schendel SA, Carlotti AE. Nasal considerations in orthognathic surgery. Am J Orthod Dentofacial Orthop. 1991;100:197-208.
- 8. Rauso R, Freda N, Curinga G, Del Pero C, Tartaro G. An Alternative Alar Cinch Suture. Eplasty 2010 Dec 20;10:e69.
- 9. Larrabee WF, Makielski KH, Henderson JL. Surgical anatomy of the face ( 2nd ed). Lippincott William and Wilkins. Philadelphia, 2004 pg 59.
- 10. O’Ryan F, Schendel S. Nasal anatomy and maxillary surgery. II: unfavorable nasolabial esthetics following the Le Fort I osteotomy. Int J Adult Orthodon Orthognath Surg. 1989;4:75-84
- 11. Millard RD. The alar base cinch in the flat, flaring nose. Plast Reconstr Surg. 1980;65:669-72.
- 12. Collins PC, Epker BN. The alar base cinch: a technique for prevention of alar base flaring secondary to maxillary surgery. Oral Surg Oral Med Oral Pathol. 1982;53:549-53.
- 13. Raithatha R, Naini FB, Patel S, Sherriff M, Witherow H. Longterm stability of limiting nasal alar base width changes with a cinch sütüre following Le Fort I osteotomy with submental intubation. Int J Oral Maxillofac Surg. 2017;46:1372-1379.
- 14. Betts NJ, Vig KW, Vig P, Spalding P, Fonseca RJ. Changes in the nasal and labial soft tissues after surgical repositioning of the maxilla. Int J Adult Orthodon Orthognath Surg 1993;8:7–23.
- 15. Mahsoub R, Naini FB, Patel S, Wertheim D, Witherow H. Nasolabial angle and nasal tip elevation changes in profile view following a Le Fort I osteotomy with or without the use of an alar base cinch sütüre: a long-term cohort study. Oral Surg Oral Med Oral Pathol Oral Radiol. 2020 Oct;130(4):379-86.
- 16. Betts NJ. Techniques to control nasal features. Atlas Oral Maxillofac Surg Clin North AM. 2000;8:53-69.
- 17. Guymon, M, Crosby DR, Wolford LM. The alar base cinch suture to control nasal width in maxillary osteotomies. Int J Adult Orthod Orthognath Surg 1988;3:89-95.
- 18. Stewart A, Edler RJ. Efficacy and stability of the alar base cinch suture. British Journal of Oral and Maxillofacial Surgery 2011;49:623–6.
- 19. Vasudavan S, Jayaratne YS, Padwa BL. Nasolabial soft tissue changes after Le Fort I advancement. J Oral Maxillofac Surg. 2012;70:e270-e277.
- 20. Metzler P, Geiger EJ, Chang CC, Sirisoontorn I, Steinbacher DM. Assessment of three-dimensional nasolabial response to Le Fort I advancement. J Plast Reconstr Aesthet Surg. 2014;67:756-63.
- 21. Westermark AH, Bystedt H, Von Konow L, Sallstrom KO. Nasolabial morphology after Le Fort I osteotomies. Effect of alar base sütüre. Int J Oral Maxillofac Surg. 1991;20:25- 30.
- 22. Esenlik E, Kaya B, Gülsen A, Çukurluoğlu O, Özmen S, Yavuzer R. Evaluation of the nose profile after maxillary advancement with impaction surgeries. J Craniofac Surg. 2011 Nov;22(6):2072-9
- 23. Van Loon B, Verhamme L, Xi T, de Koning MJ, Bergé SJ, Maal TJ.Three-dimensional evaluation of the alar cinch suture after Le Fort I osteotomy. Int J Oral Maxillofac Surg. 2016 Oct;45(10):1309-14.
- 24. Muradin MS, Rosenberg A, Van der Bilt A, Stoelinga PJ, Koole R. The effect of alar cinch sutures and V–Y closure on soft tissue dynamics after Le Fort I intrusion osteotomies. J Craniomaxillofac Surg 2009;37:334–40.
- 25. Howley C, Ali N, Lee R, Cox S. Use of the alar base cinch suture in Le Fort I osteotomy: is it effective? Br J Oral Maxillofac Surg 2011;49:127–30.
Öz
Objective
The purpose of this study was to evaluate the effect of cinch suture to prevent enlargement in the nasal tissue of 15 patients who
maxillary advancement and impaction surgery with Lefort I osteotomy.
Material and methods
This study 15 orthognathic surgery patients (9 female, 6 male) underwent maxillary advancement and impaction surgery with
Lefort I were included. While the average amount of advancement of the upper jaw is 5±1.55 mm; impaction amount is 2.5±0.83
mm. The patients were seperated into two groups, cinch suture performed (cinch suture group) and cinch suture not performed
(control group). Before the operation the width lateral point of nose wings alar wideness (AW) and the joint that nose wings
with face on base inferior subalar wideness (SAW) was assigned. Nasolabial angle (NLA) was determined on cephalometric
radiographs taken before and after surgery. The mean follow-up period of the study was 7.2±0.8 months. All datas from this
study was analized by ‘Statistical Packages for the Social Science’ statistical programme.
Results
After orthognatic surgery a significant increased on AW point observed on both group the cinch sütüre performed and the control
group. While the difference between the groups in AG was not significant (p=0.463), the difference between the groups in SAG
was significant (p=0.047). NLA measurements after orthognathic surgery decreased in the cinch suture group (p=0.182) and
increased in the control group (p=0.865).
Conclusion
Despite cinch suture increased observed on both AW and SAW point after Lefort 1 osteotomy. We can say that while cinch suture
finded beneficial to contain the enlargement of SAW, finded insufficient for prevention of enlargement AW. In our study, no
significant effect of cinch suture on NLA was found. In contrast to cinch suture the risk of enlargement nasal wings should be
considered and the patient should be informed before the operation.
Anahtar Kelimeler
Kaynakça
- 1. Betts NJ, Edwards SP. Soft Tissue Changes Associated with Orthognathic Surgery. Milaro M. editor. Peterson’s Principles of Oral and Maxillofacial Surgery; 2nd ed. Vol.2. Ontario, Canada: BC Decker Inc, 2004. Chapter 59.
- 2. Ryan FS, Barnard M, Cunningham SJ. What are orthognathic patients’ expectations of treatment outcome—a qualitative study. J Oral Maxillofac Surg. 2012;70:2648-55.
- 3. Mani V, Panicker P, Shenoy A, George AL, Chacko T. Evaluation of Changes in the Alar Base Width Following Lefort 1 and AMO with Conventional Alar Cinch Suturing: A Photographic Study of 100 Cases. J Maxillofac Oral Surg. 2020;19(1):21-5.
- 4. Liu X, Zhu S, Hu J. Modified versus classic alar base sutures after LeFort I osteotomy: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014 Jan;117(1):37-44
- 5. Bell WH, Proffit W. Esthetic effects of maxillary osteotomy. In: Bell WH, White RP, editors. Surgical correction of dentofacial deformities. Philadelphia: WB Saunder 1980 Tamer Y. et al. Page 91 p. 368–70.
- 6. Cunningham SJ, Hunt NP, Feinmann C. Psychological aspects of orthognathic surgery: a review of the literature. Int J Adult Orthodon Orthognath Surg. 1995;10(3):159-72. 7. Schendel SA, Carlotti AE. Nasal considerations in orthognathic surgery. Am J Orthod Dentofacial Orthop. 1991;100:197-208.
- 8. Rauso R, Freda N, Curinga G, Del Pero C, Tartaro G. An Alternative Alar Cinch Suture. Eplasty 2010 Dec 20;10:e69.
- 9. Larrabee WF, Makielski KH, Henderson JL. Surgical anatomy of the face ( 2nd ed). Lippincott William and Wilkins. Philadelphia, 2004 pg 59.
- 10. O’Ryan F, Schendel S. Nasal anatomy and maxillary surgery. II: unfavorable nasolabial esthetics following the Le Fort I osteotomy. Int J Adult Orthodon Orthognath Surg. 1989;4:75-84
- 11. Millard RD. The alar base cinch in the flat, flaring nose. Plast Reconstr Surg. 1980;65:669-72.
- 12. Collins PC, Epker BN. The alar base cinch: a technique for prevention of alar base flaring secondary to maxillary surgery. Oral Surg Oral Med Oral Pathol. 1982;53:549-53.
- 13. Raithatha R, Naini FB, Patel S, Sherriff M, Witherow H. Longterm stability of limiting nasal alar base width changes with a cinch sütüre following Le Fort I osteotomy with submental intubation. Int J Oral Maxillofac Surg. 2017;46:1372-1379.
- 14. Betts NJ, Vig KW, Vig P, Spalding P, Fonseca RJ. Changes in the nasal and labial soft tissues after surgical repositioning of the maxilla. Int J Adult Orthodon Orthognath Surg 1993;8:7–23.
- 15. Mahsoub R, Naini FB, Patel S, Wertheim D, Witherow H. Nasolabial angle and nasal tip elevation changes in profile view following a Le Fort I osteotomy with or without the use of an alar base cinch sütüre: a long-term cohort study. Oral Surg Oral Med Oral Pathol Oral Radiol. 2020 Oct;130(4):379-86.
- 16. Betts NJ. Techniques to control nasal features. Atlas Oral Maxillofac Surg Clin North AM. 2000;8:53-69.
- 17. Guymon, M, Crosby DR, Wolford LM. The alar base cinch suture to control nasal width in maxillary osteotomies. Int J Adult Orthod Orthognath Surg 1988;3:89-95.
- 18. Stewart A, Edler RJ. Efficacy and stability of the alar base cinch suture. British Journal of Oral and Maxillofacial Surgery 2011;49:623–6.
- 19. Vasudavan S, Jayaratne YS, Padwa BL. Nasolabial soft tissue changes after Le Fort I advancement. J Oral Maxillofac Surg. 2012;70:e270-e277.
- 20. Metzler P, Geiger EJ, Chang CC, Sirisoontorn I, Steinbacher DM. Assessment of three-dimensional nasolabial response to Le Fort I advancement. J Plast Reconstr Aesthet Surg. 2014;67:756-63.
- 21. Westermark AH, Bystedt H, Von Konow L, Sallstrom KO. Nasolabial morphology after Le Fort I osteotomies. Effect of alar base sütüre. Int J Oral Maxillofac Surg. 1991;20:25- 30.
- 22. Esenlik E, Kaya B, Gülsen A, Çukurluoğlu O, Özmen S, Yavuzer R. Evaluation of the nose profile after maxillary advancement with impaction surgeries. J Craniofac Surg. 2011 Nov;22(6):2072-9
- 23. Van Loon B, Verhamme L, Xi T, de Koning MJ, Bergé SJ, Maal TJ.Three-dimensional evaluation of the alar cinch suture after Le Fort I osteotomy. Int J Oral Maxillofac Surg. 2016 Oct;45(10):1309-14.
- 24. Muradin MS, Rosenberg A, Van der Bilt A, Stoelinga PJ, Koole R. The effect of alar cinch sutures and V–Y closure on soft tissue dynamics after Le Fort I intrusion osteotomies. J Craniomaxillofac Surg 2009;37:334–40.
- 25. Howley C, Ali N, Lee R, Cox S. Use of the alar base cinch suture in Le Fort I osteotomy: is it effective? Br J Oral Maxillofac Surg 2011;49:127–30.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Ağız, Yüz ve Çene Cerrahisi |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Erken Görünüm Tarihi | 22 Aralık 2023 |
| Yayımlanma Tarihi | 25 Aralık 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 2 Sayı: 4 |
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