Efficacy and stability of the alar base cinch suture

The alar base cinch suture is designed to prevent excessive flaring of the nose after Le Fort 1 osteotomy of the maxilla. However, it is difficult to measure the effect of the suture on nasal width during the operation in the presence of a nasal endotracheal tube, and the long-term stability of the manoeuvre has not been well-documented. We have investigated the efficacy and stability of the alar base cinch suture by measuring nasal width in 36 patients before, during, and 12 months after, bimaxillary surgery with submental intubation. The use of submental intubation facilitated accurate measurement of the changes in nasal width produced by the osteotomy and the cinch suture. Intraoperative measurements showed that there was a mean increase in the width of the base of the nose of 3.0 mm, 9% (right and left alar points, al-al) and 3.6 mm, 11% (right and left alar curvature points, ac-ac) after the osteotomy, and that the cinch suture produced a reduction in these increases of 1.6 mm, 53% (al-al), and 2.1 mm, 58% (ac-ac). Measurements taken after the operation at 3, 6, and 12 months showed no significant changes. This indicates that our method of cinch suturing is effective in mitigating the increase in nasal width that is produced by the osteotomy, and that this effect is stable in the medium term.