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RhinoplastyNCT03213548

Aesthetic and Functional Results of Alar Base Modifications in Rhinoplasty

A study testing Alar facial groove incision and Alar facial groove spared in people with Rhinoplasty and Surgical Procedure, Unspecified, run by Hospital de Clinicas de Porto Alegre at 1 site in Brazil.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Rhinoplasty is among the most accomplished aesthetic procedures in Plastic Surgery. The mastery of Alar Base modifications is essential for superior aesthetic results. The main indication is to reduce nasal width when it exceeds the intercanthal distance in Caucasian women. Read more about this study

Who is it for?
Ages 16 years and older
What is being tested?
Alar facial groove incision and Alar facial groove spared
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
50 participants
Where
1 siteBrazil
Study dates
15 Sep 2017to 15 Sep 2020
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 16 years and older
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Patients from The Department of Otolaryngology of HCPA Hospital who are candidates for functional and / or aesthetic rhinoplasty over 16 years of age, with an indication of alar base modification, will be candidates for the study.
  • The alar base modification is indicated when the columella-alar distance is greater than the intercanthal distance, when there is presence of asymmetries between the nostrils or its size is too width. In corrections of overprojected noses, there may be enlargement of the base of the alar, with an indication of reduction of the width of the alar at the end of the procedure.

Who cannot join

  • Patients who present (1) Previous alar base surgery modification ; (2) keloid / hypertrophic scar history and (3) Patients with cheek - alar border obtuse angle

Trial locations and contacts

1 site in 1 country.

João Pedro Garcia, MD contact

+5551996154290

jptg@terra.com.br

João Pedro Garcia, MD contact

+55996154290

jptg@terra.com.br

Brazil1 site
  • Hospital de Clinicas de Porto Alegre

    Porto Alegre, Rio Grande do Sul, 90035-003

    João Pedro Garcia, MD, +55996154290, jptg@terra.com.br

Other trials in Brazil

About this study

Official title: Aesthetic and Functional Results of Alar Base Modifications in Rhinoplasty : A Randomized Clinical Trial

Rhinoplasty is among the most accomplished aesthetic procedures in Plastic Surgery. The mastery of Alar Base modifications is essential for superior aesthetic results. The main indication is to reduce nasal width when it exceeds the intercanthal distance in Caucasian women. Other indications are the modification of the shape of the nostrils or to reduce alar flare in noses with too convex alar base. Since Wier's first description, a series of techniques has been developed with a common goal of making the basal view of the nose close to an equilateral triangle. The location and amount of tissue to be removed will be according to the preoperative or intraoperative indication due to changes in the alar base resulting from reductions in the projection of the nasal tip. One of the controversies in the literature is in the position of the incision in alar base modifications. Some authors prioritize incisions that do not violate the alar facial groove , since the groove region presents a greater number of sebaceous glands, leading to poor scarring results. Other authors have argued that incisions above the sulcus have caused more evident scars, anda that poor healing results would be more associated with aggressive resections of border and bad closing skin techniques.

Due to divergence in the literature, the present study aims to compare, through a double blinded randomized clinical trial, two techniques of alar base modifications that will differentiate only by violating or not the alar facial groove.

Read the detailed description

The study was performed at the Otorhinolaryngology service Clinicas Hospital of Porto Alegre ( HCPA). Patients who meet the inclusion and exclusion criteria will be invited to participate in the study. All patients who agree to participate in the study, filling out an Informed Consent Form, will have their preoperative consultation registered. Pre- and postoperative follow-up will be performed at the otorhinolaryngology service of HCPA. Patients will be allocated randomly in the intervention and control groups, in blocks of 6, using a computer generated random sequence of numbers. . The allocation will be kept confidential for the patient and for the researchers responsible for measuring the outcomes. intervention group will be submitted to surgical modification of the alar base with incisions in the alar facial groove, the control group will be submitted to a similar technique, but it will save groove.

The surgical technique will be based on a sequential approach based on the 2010 publication Adamnson et al in the Archives of Facial Plastic Surgery "Alar Soft-Tissue Techniques in Rhinoplasty Algorithmic Approach, Quantifiable Measurement of outcomes will be performed by trained and blinded research team members for intervention allocation. Patients will be evaluated at the preoperative visit, and will return to consultations on days 7, 14.30, 60, 90.360 postoperative days, when they will be photographed at the incidences, frontal, ¾ profile, basal, between tip with Eyebrows. At the base line and at 90 postoperative days the following outcomes will be measured: Stony Brook Scale , ROE Scale, Visual Analogue Scale - Satisfaction with aesthetic aspect of the nose, Visual Analogue Scale Intensity of nasal obstruction and NOSE Scale For the comparison of continuous variables will be compared using Student's t test for independent samples or Mann-Whitney non-parametric test, when appropriate. Multivariate analysis will be performed to control confounding factors.

Being tested
Alar facial groove incision, Alar facial groove spared
Keywords
alar base reduction, alar facial groove, alectomy, Flare, Nose
Medical subject headings
Cicatrix

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Alar facial groove incisionProcedure or surgery

    All procedures related to alterations in the alar base will be based on an algorithm proposed by 2010 Adamnson et al lar Soft-Tissue Techniques in Rhinoplasty Algorithmic Approach, Quantifiable Guidelines, and Scar Outcomes From a Single Surgeon Experience ,published at Archives Facial Plastic Surgery in which a sequential approach is used, evaluating step-by-step surgical needs. Initially, the alar base can be reduced by removing tissue from the nasal sill. At this step, modifications at the shape or the width of the nostrils can be done. After that, a rotation-advancement flap is made, and the sill defect is closed. The nasal flair is then assessed and tissue from the alar border can be removed if needed. The incisions not spare the alar facial groove.

  • Alar facial groove sparedProcedure or surgery

    The technique is the same of the Alar facial groove incision intervention group, but the incisions spare the groove. The incisions will be at 1 mm above the groove.

Study groups in NCT03213548
Study groupRoleWhat they receive
Alar facial groove IncisionExperimentalAlar Base surgical modification with surgical inions in the alar facial groove
Receives: Procedure: Alar facial groove incision
Alar facial groove sparedActive comparatorAlar Base surgical modification with surgical incisions 1mm above the alar facial groove
Receives: Procedure: Alar facial groove spared

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Stony Brook Scar Evaluation Scale (SBSES)

    Patients will be evaluated personally by blinded examiners who will graduate the scars according to the standardized Stony Brook scoring evaluation scar which has a minimum score of 0 and a maximum score of 5 points according to 5 characteristics of the scar ( width, height, color, hatch/suture mark, overall appearance)

    Measured: 90 days

Secondary outcomes (4)
  1. Rhinoplasty Outcome Evaluation (ROE) Scale

    The Rhinoplasty Outcome Evaluation (ROE) scale is an easy-to-use questionnaire, designed for the evaluation of rhinoplasty results. This instrument is composed of six questions that assess three domains of quality of life: physical, mental / emotional and social. Each question is scored on a scale of 0 to 4 and converted to a total score of 0 to 100, dividing the value by 24 and multiplying by 100. A score above 85 is considered excellent and generally means that the patient is very satisfied. However, the comparison of pre and postoperative values usually provide the most relevant information. Patients will be asked to respond to this scale in the base line and at 90 postoperative days.

    Measured: base line and 90 posoperative days

  2. Visual Analogue Scale - Satisfaction with aesthetic aspect of the nose

    Patients will be asked to complete an analogue-visual scale (Annex 3) indicating the degree of satisfaction with the appearance of their nose. This scale will be converted into a scale ranging from 0 to 10, and the value 10 represents the highest satisfaction level possible. The scale will be applied in the base line as well as in the 90 postoperative days.

    Measured: base line and 90 posoperative days

  3. Intensity of nasal obstruction

    Patients will be asked to complete an analogue-visual scale indicating the severity of their nasal obstruction that will be converted from 0 to 10, and the value 10 represents symptoms of nasal obstruction of greater intensity. The scale will be applied at the base line, as well as at the 90 postoperative days.

    Measured: base line and 90 posoperative days

  4. NOSE Scale

    The NOSE (Nasal Obstruction Symptom Evaluation Scale) scale will be used to measure the quality of life related to nasal obstruction. It is a validated instrument specifically designed for use in patients with nasal obstruction. According to this scale patients are asked to evaluate difficulty breathing in a general way and specifically the difficulty in breathing through the nose, breathing during sleep, and severity of their nasal congestion. The severity of the symptoms is recorded on a scale of 0 to 4, with 0 being the absence of a problem and 4 being a serious problem. The possible scores range from 0 to 20 and the higher scores indicate a higher degree of nasal obstruction. The sum of the scores is multiplied by 5 so as to obtain a final score ranging from 0 to 100, with higher values associated with poorer quality of life.

    The scale will be applied at the base line and at 90 postoperative days.

    Measured: base line and 90 posoperative days

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 Jul 2017
  2. Study start15 Sep 2017 (estimated)
  3. Primary completion15 Sep 2019 (estimated)
  4. Study completion15 Sep 2020 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
double blind clinical trial
Masking
None (open label)
Enrolment
50 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03213548
Sponsor's protocol ID
59622316.0.0000.5327
Status last verified
Jul 2017
First submitted
28 Jun 2017
Last updated
11 Jul 2017
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Rohrich RJ, Ahmad J. Rhinoplasty. Plast Reconstr Surg. 2011 Aug;128(2):49e-73e. doi: 10.1097/PRS.0b013e31821e7191.

    PubMed 21788798
  • Kridel RW, Castellano RD. A simplified approach to alar base reduction: a review of 124 patients over 20 years. Arch Facial Plast Surg. 2005 Mar-Apr;7(2):81-93. doi: 10.1001/archfaci.7.2.81.

    PubMed 15781717
  • Warner JP, Chauhan N, Adamson PA. Alar soft-tissue techniques in rhinoplasty: algorithmic approach, quantifiable guidelines, and scar outcomes from a single surgeon experience. Arch Facial Plast Surg. 2010 May-Jun;12(3):149-58. doi: 10.1001/archfacial.2010.30.

    PubMed 20479430
  • Bennett GH, Lessow A, Song P, Constantinides M. The long-term effects of alar base reduction. Arch Facial Plast Surg. 2005 Mar-Apr;7(2):94-7. doi: 10.1001/archfaci.7.2.94.

    PubMed 15781718
  • Weir RF. On restoring sunken noses without scarring the face. 1892. Aesthetic Plast Surg. 1988 Nov;12(4):203-6. No abstract available.

    PubMed 3068968
  • Patel AD, Kridel RW. African-American rhinoplasty. Facial Plast Surg. 2010 May;26(2):131-41. doi: 10.1055/s-0030-1253499. Epub 2010 May 4.

    PubMed 20446207
  • Foda HM. Nasal base narrowing: the combined alar base excision technique. Arch Facial Plast Surg. 2007 Jan-Feb;9(1):30-4. doi: 10.1001/archfaci.9.1.30.

    PubMed 17224485
  • Boyette JR, Stucker FJ. African American rhinoplasty. Facial Plast Surg Clin North Am. 2014 Aug;22(3):379-93. doi: 10.1016/j.fsc.2014.04.004.

    PubMed 25049123
  • Stucker FJ, Lian T, Sanders K. African American rhinoplasty. Facial Plast Surg Clin North Am. 2005 Feb;13(1):65-72. doi: 10.1016/j.fsc.2004.04.010.

    PubMed 15519928
  • Porter JP. The average African American male face: an anthropometric analysis. Arch Facial Plast Surg. 2004 Mar-Apr;6(2):78-81. doi: 10.1001/archfaci.6.2.78.

    PubMed 15023793
  • Tardy ME Jr, Patt BS, Walter MA. Alar reduction and sculpture: anatomic concepts. Facial Plast Surg. 1993 Oct;9(4):295-305. doi: 10.1055/s-2008-1064623. No abstract available.

    PubMed 8181769
  • Hagan KF. Clinical photography for the plastic surgery practice--the basics. Plast Surg Nurs. 2008 Oct-Dec;28(4):188-92; 193-4. doi: 10.1097/01.PSN.0000342822.44387.c5.

    PubMed 19092585
  • Swamy RS, Sykes JM, Most SP. Principles of photography in rhinoplasty for the digital photographer. Clin Plast Surg. 2010 Apr;37(2):213-21. doi: 10.1016/j.cps.2009.12.003.

    PubMed 20206739
  • Lima LF, Arroyo HH, Jurado JR. Update in alar base reduction in rhinoplasty. Curr Opin Otolaryngol Head Neck Surg. 2016 Aug;24(4):316-21. doi: 10.1097/MOO.0000000000000277.

    PubMed 27261942

Questions about this trial

What is this clinical trial studying?

A study testing Alar facial groove incision and Alar facial groove spared in people with Rhinoplasty and Surgical Procedure, Unspecified, run by Hospital de Clinicas de Porto Alegre at 1 site in Brazil.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 11 Jul 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Brazil. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact João Pedro Garcia, MD (+5551996154290, jptg@terra.com.br), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Stony Brook Scar Evaluation Scale (SBSES) (time frame: 90 days). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03213548, which also lists 14 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Jul 2017.

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