Does Subspinal Le Fort I Osteotomy Reduce Nasolabial Soft Tissue Changes Compared to the Conventional Technique?

Area of Science:

• Oral and Maxillofacial Surgery
• Orthognathic Surgery
• Craniofacial Anatomy

Background:

• Le Fort I osteotomy (LFIO) can cause undesirable nasolabial changes.
• Subspinal osteotomy is a modified technique aiming to preserve perinasal structures and minimize these alterations.

Purpose of the Study:

• To compare the effects of conventional LFIO versus subspinal LFIO on nasolabial soft tissue changes.
• To evaluate differences in alar base width, upper lip dimensions, and nasolabial angle between the two surgical techniques.

Main Methods:

• Retrospective cohort study (2019-2023) of 96 patients undergoing conventional or subspinal LFIO.
• Outcome variables included interalar width, alar base width, upper lip dimensions, and nasolabial angle, measured preoperatively and postoperatively.
• Statistical analyses included descriptive statistics, group comparisons, and correlation/regression analyses.

Main Results:

• Subspinal LFIO showed significantly less alar base widening (0.55 mm) than conventional LFIO (1.85 mm).
• Conventional LFIO resulted in significantly greater upper lip lengthening (1.26 mm) compared to subspinal LFIO (0.3 mm).
• No significant differences were observed in interalar width or nasolabial angle between the groups.

Conclusions:

• Subspinal osteotomy is associated with reduced alar base widening and upper lip lengthening compared to conventional LFIO.
• This suggests subspinal osteotomy may offer better preservation of nasolabial aesthetics.
• The findings support subspinal osteotomy as a valuable alternative for patients seeking to minimize soft tissue changes after LFIO.