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  • Title: Is the Pyriform Ligament Important for Alar Width Maintenance After Le Fort I Osteotomy?
    Author: Peacock ZS, Susarla SM.
    Journal: J Oral Maxillofac Surg; 2015 Dec; 73(12 Suppl):S57-66. PubMed ID: 26608155.
    Abstract:
    PURPOSE: To determine whether identification and incorporation of the pyriform ligament in the alar cinch results in decreased alar base widening compared with standard alar cinch techniques. MATERIALS AND METHODS: This was a retrospective case series and the sample was composed of patients undergoing Le Fort I osteotomy. Intraoperatively, the pyriform ligament was identified and incorporated in the alar cinch suture. Greatest alar width (GAW) measured immediately after closure was compared with GAW measured at least 5 months postoperatively. The change in alar base width was compared with that reported in the literature using other alar cinch techniques. Two case examples are reported. RESULTS: The sample was composed of 15 patients (mean age, 27.1 yr; 27% female). The mean postoperative change in GAW was 1.0 ± 0.6 mm (2.59 ± 1.59%). Postoperative change in alar base width reported in the literature ranged from 0.5 to 10.8%. CONCLUSION: The pyriform ligament is easily identified during exposure of the maxilla and pyriform aperture and can be used to control widening of the alar base after Le Fort I osteotomy.
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