3. Binder’s syndrome: Modified approach for correction of Nasomaxillary hypoplasia.

• Main Authors: Dr. Nilesh Ghelani, Dr. Sankit Shah, Dr. Hardik Ponkiya, Dr. Arvind Kaushal
• Format: Article
• Language: English
• Published: B.J.Medical College Development Society, Ahmedabad 2019-12-01
• Series: BJ Kines: National Journal of Basic & Applied Sciences
• Subjects: binder’s syndrome; costal cartilage grafts; extra oral only approach
• Online Access: http://bjkines.com/vol11dec19/paper3d19fulltext.pdf

Introduction: Binder syndrome is a relatively uncommon syndrome characterized by nasomaxillary hypoplasia. Different approaches for correction of hypoplastic nasomaxillary complex has been developed and studied over years. Our study shows our experience with extra oral only technique of onlay costal cartilage graft for nasal dorsal augmentation, premaxilla augmentation and columella lengthening in three patients. Materials and Method: We report here three patients with nasomaxillary dysplasia whose noses were corrected with onlay costal cartilage grafts using external rhinoplasty approach for nasal dorsal augmentation, columellar lengthening, and premaxillary augmentation. L struts made for nasal augmentation, columellar lengthening, and premaxillary augmentation were fixed to one another by putting it in dissected pockets. Results: All the patients were operated single time. Patients were followed up with sequential photography over 6 months to 2 years. Costal cartilage maintained their volume in post operative period. Conclusion: Binder's Syndrome: Augmentation of the premaxilla is necessary along with nasal augmentation and columellar lengthening with autogenous costal cartilage grafts for effective treatment. Augmentation with costal cartilage is enough to give an aesthetically pleasing facial profile in mild to moderate cases.