Changes in nasal soft tissue morphology following Le Fort I osteotomy of the maxilla: evaluation using a...

This study aimed to investigate the factors affecting alar width after Le Fort I osteotomy. A prospective observational study was conducted on 84 patients who underwent orthodontic treatment followed by Le Fort I osteotomy, with or without bilateral sagittal split ramus osteotomy. Measurements of alar width, alar base width, and nasal tip protrusion were obtained using a three-dimensional camera before surgery and on postoperative days 3, 7, 60, and 90. The sella-nasion-A point (SNA) angle was assessed from lateral cephalometric radiographs to evaluate maxillary movement. Postoperatively, alar width increased by 2.33 ± 1.24 mm. Significant correlations were observed between alar width increase and preoperative alar width (P = 0.002), facial changes (P < 0.001), and SNA angle (P = 0.003). Although previous studies have emphasized bony segment movement as the main factor influencing nasal width, multivariate analysis in the present study revealed that preoperative alar width (P = 0.003) and facial changes (P = 0.002) had a stronger correlation with alar width expansion than with SNA angle (P = 0.027). In conclusion, postoperative alar widening is influenced by multiple factors, including nasal morphology and bone movement. Further studies are needed to clarify these mechanisms to improve the control of nasal morphological changes following Le Fort I osteotomy.