Temporal Changes in Nasal Width After Le Fort I Osteotomy With Modified Alar Cinch Suture Technique

Le Fort I osteotomy (LFI) is commonly performed to correct maxillary deformities; however, it often results in undesirable changes to nasal morphology, particularly widening of the nasal width. The short-term course of nasal width stabilization remains poorly defined, and no indicators have been identified for changes in nasal width during the first postoperative year following LFI. This study examined temporal changes in nasal width following LFI with a modified cinch suture technique, applied by a single surgeon. Twenty-six patients were analyzed using standardized anthropometric measurements and CT imaging. Intra-examiner repeatability was excellent (intraclass correlation coefficient =0.96, 95% CI: 0.87-0.99), with Bland-Altman analysis showing a small mean bias (0.49 mm) and clinically acceptable limits of agreement (-1.44 to 2.42 mm). The cinch suture reduced nasal width by an average of 6.46 mm (16.33%) intraoperatively. Postoperatively, the nasal width gradually increased before stabilizing, with a mean stabilization period of 3.78 months (median, 3 months). At 1 year postoperatively, nasal width increased by 0.74 mm (2.01%) compared with the preoperative measurement. No correlation was found between stabilization period and patients' demographic or clinical factors. Compared with previous reports, the technique achieved a smaller increase in nasal width at 1 year. The consistent stabilization around 3 months suggests its potential as a clinical indicator for postoperative monitoring. Limitations include the single-surgeon design and variability in individual healing and swelling. Future research should classify cinch suture techniques by type and systematically evaluate nasal- and soft-tissue changes following LFI.