A novel single-rib recombination method in binder syndrome treatment

Binder syndrome is a congenital deformity around the maxillofacial area. Its 2 most distinctive characteristics are flattened nose and midfacial retrusion. Various methods and materials, such as the use of silicon, costal bone, and costal cartilage, have been proposed for the treatment of the disease.

We harvested only the seventh costal cartilage including partial costal bone of the same rib to correct all the deformities. The rib was divided into 3 parts: 1 I-shaped cartilage, 1 inverted-T-shaped cartilage, and 1 C-shaped implant (later divided into a C and a reversed-C implant) composed of rib bone and cartilage. The first 2 parts were constructed to an L-shaped implant for nasal dorsum augmentation, collumella support, and nasal base elevation. The C-shaped and reversed-C-shaped implants were placed on both sides of the pyriform aperture.

No apparent deviation on the nasal support was found. Outcome evaluation questionnaires received a mean score of 9 of 10. The patients recovered well and were very satisfied with the results, and postoperative period was uneventful.