Alar width changes due to surgically-assisted rapid palatal expansion: A meta-analysis

Area of Science:

• Oral and Maxillofacial Surgery
• Plastic Surgery
• Orthodontics

Background:

• Orthognathic surgery aims for aesthetic outcomes, but soft tissue changes can impact results.
• Surgically-assisted rapid palatal expansion (SARPE) is a common procedure for maxillary expansion.
• Understanding changes in alar base width (ABW) is important for predicting facial aesthetics post-SARPE.

Purpose of the Study:

• To investigate changes in alar base width (ABW) after surgically-assisted rapid palatal expansion (SARPE).
• To quantify the average change in ABW using a meta-analysis of existing studies.

Main Methods:

• Systematic literature search of multiple databases (PubMed, Scopus, Web of Science, etc.) up to September 2015.
• Inclusion of studies detailing SARPE with specific surgical techniques and V-Y closure.
• Random effects meta-analysis to determine the mean difference in ABW pre- and post-surgery.

Main Results:

• A statistically significant increase in alar base width (ABW) of +1.74 mm (95% CI [0.14, 3.34]) was observed post-SARPE.
• No significant statistical heterogeneity was found among the included studies (χ² = 0.03; df = 2; P = 0.98).
• Alar base width increases were consistent even when including patients with cinched procedures.

Conclusions:

• SARPE leads to a predictable increase in alar base width.
• This finding has implications for surgical planning and achieving optimal aesthetic outcomes in orthognathic surgery.
• Limitations include potential bias in the included studies, such as measurement bias and small sample sizes.