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This paper from Belgium highlights completing a sub-spinal cortectomy of the anterior nasal spine during the procedure of surgically assisted rapid palatal expansion (SARPE) as a means of reducing the alar and columella width as well as the nasolabial angle. Nasal changes are well recognised during Le Fort I osteotomy or palatal expansion and can often be a significant source of concern. Their trial involved 64 patients; in 32, no cortectomy was completed and in 32 it was. Measurements were undertaken using 3D stereophotogrammetry images and whilst both groups showed a statistically significant increase in alar and columella width, changes were significantly smaller in the group with the anterior nasal spine cortectomy.

The effect of subspinal Le Fort I cortectomy.
Michaux D, Van de Casteele E, Dielen D, et al.
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Stuart Clark

Manchester Royal Infirmary, Manchester, UK.

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