https://doi.org/10.1177/0003489420943910 Annals of Otology, Rhinology & Laryngology 1–7 © The Author(s) 2020 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/0003489420943910 journals.sagepub.com/home/aor Original Article Introduction Cyanoacrylate (CA) glues have been successfully used in different surgical procedures 1-3 because they are safe and yield comparable results to suturing. 4 CA glues are extremely useful for vascular anastomosis because they are simpler to use than traditional suture and they offer comparable results in term of outcome. 5 CA glues, despite generally safe, can sometimes cause infection in the site where they are applied 6 or dermatitis. 7 An adverse event could be due to subject’s sensitivity to the active principle or to one of the excipients contained in the glue. Literature reports different prevalence of infection (up to a complete absence) based on the brand and formulation used. 8,9 CA glues are safe and valid to suture soft tissues after traumatic injury 10 or, in place of traditional sutures, in areas with a high risk of infection as mouth 11 ; these glues rarely cause infection. 10,11 In addition to soft tissue, CA glues, thanks to their high adhesive and hemostatic properties, 943910AOR XX X 10.1177/0003489420943910Annals of Otology, Rhinology & LaryngologyCarmine et al research-article 2020 1 University Hospital of Salerno, Italy 2 The nose clinic, rhinosurgery unit c/o check-up day-surgery Salerno, Italy 3 Organ of Sense Department, La Sapienza University of Rome, Italy 4 Department of Oral Maxillo-Facial and Facial Plastic Surgery, University of Manchester, Manchester, UK 5 Head and Neck Department, Neurosciences, Reproductive and Odontostomatological Science, University Federico II, Naples, Italy 6 Otolaryngology Department, University of Perugia, Perugia, Italy Corresponding Author: Di Stadio Arianna, MD, PhD, Otolaryngology Department, University of Perugia, Piazza Menghini 1, Perugia, 06126, Italy. Emails: ariannadistadio@hotmail.com; arianna.distadio@unipg.it A Prospective Randomized Trial of N-butyl-cyanoacrylate + Metacryloxysulfolane Adhesive versus Suture Alone for Grafting in Rhinoplasty: 9 year Follow-up Martino Carmine, MD 1,2 , Salzano Francesco, MD 1 , Martino Diletta, MD 2 , Ralli Massimo, MD, PhD 3 , De Vincentiis Marco, MD 3 , Maranzano Massimo, MD 4 , Greco Antonio, MD 3 , Salzano Giovanni, MD 5 , and Di Stadio Arianna, MD, PhD 6 Abstract Objective: Use of cyanoacrylate glue in facial plastic surgery is still controversial due to the absence of long-term follow up showing the results. Aim of our study is comparing the long-term outcomes of N-butyl-cyanoacrylate + Metacryloxysulfolane versus traditional sutures in rhinoplasty. Methods: Prospective comparative study. One hundred forty-two patients affected by ptotic nasal tip were included and randomized in two groups. In group A, the surgeon fixed the graft by using the glue and suture and in group B by using the traditional suture only. The following data were collected and compared by statistical analysis: nasolabial angle before and after surgery, dimensions of the graft, duration time (in minutes) for graft application during the surgery, number of sutures applied to fix the graft, presence of post-surgery negative outcomes. Results: All patients statistically improved their nasolabial angle after surgery (ANOVA: P < .0001) without statistically significant differences between the two groups both at short and long follow-up ( χ :P = 1 and P = .9 respectively). A statistically significant difference in graft fixation time (P < .00001) and number of sutures (t: P < .00001) used was observed between the two groups. No statistically significant difference was observed in prevalence of infection after surgery. Conclusion: N-butyl-cyanoacrylate + Metacryloxysulfolane could be a valid tool to reduce the necessary number of sutures and to reduce the time required for graft fixation graft fixation with consistent results in long-term follow-up. Keywords rhinoplasty, nasal graft, cyanoacrylate, suture, long-term results