Maxillonasal dysplasia (Binder's syndrome)

Area of Science:

• Craniofacial Surgery
• Orthodontics
• Pediatric Plastic Surgery

Background:

• Binder's syndrome, also known as nasomaxillary hypoplasia, presents significant challenges in facial development.
• Early and accurate diagnosis is crucial for effective management.

Purpose of the Study:

• To review treatment strategies for Binder's syndrome.
• To evaluate the efficacy of different surgical and orthodontic interventions based on patient presentation.

Main Methods:

• Retrospective analysis of eleven patients treated between 1972 and 1977.
• Treatment modalities included onlay bone/cartilage grafts for younger children or those with normal occlusion.
• Le Fort I and/or Le Fort II osteotomies were performed for older children with severe malocclusion; interceptive orthodontics were used for less severe cases.

Main Results:

• Onlay grafts were effective for nasal and perialar augmentation in select cases.
• Osteotomies successfully corrected severe malocclusion in older patients.
• A combined surgical approach through frontal craniotomy and buccal sulcus incisions allowed for significant nasal lengthening and enlargement without visible facial scarring.

Conclusions:

• Treatment for Binder's syndrome should be individualized based on age and severity of malocclusion.
• A combination of grafting, osteotomy, and orthodontics can achieve substantial aesthetic and functional improvements.
• The described surgical approach offers a method for significant nasal reconstruction with minimal external scarring.