Nasomaxillary osteotomy for the correction of Binder's syndrome (nasomaxillary dysplasia)

The treatment of Binder's syndrome, especially the reconstruction of the nose, has been challenging in the past. Although the Class III malocclusion can be corrected by a Le Fort I or II osteotomy, the rudimentary anterior nasal spine, the piriform rim, and the anterior maxilla remain retruded in relation to the rest of the maxilla and other facial structures. Nasal reconstruction based on this retruded potential anchor is difficult and probably the cause of unsatisfactory results. Surgical advancement of the nasal base by means of a nasomaxillary osteotomy not only simplifies the nasal reconstruction but also improves the esthetic results. The surgical technique is described and results are demonstrated by treated cases.