CORRECTION OF THE NASAL AND PREMAXILLARY AREAS IN PATIENTS WITH BINDER’S SYNDROME: 2 YEARS FOLLOW-UP STUDY.

Abstract

Background: Nasomaxillary hypoplasia is a rare congenital disorder involving the central face. It imparts a distinctive appearance to the individual face as the age advances. Severity of the disorder varies, so do the manifestations.

Methods: This retrospective study was carried out in the Deparment of Burn and Plastic surgery in Government Medical College and Hospital Bettiah, Bihar, India from May 2019 to March 2020. Total 20 cases of nasomaxillary hypoplasia (Binder’s syndrome) selected from case records and photographs of 600 cases of rhinoplasties performed between May 2019 to march 2020. Diagnosis of Binder’s syndrome was based on the typical features. About 20 cases of nasomaxillary hypoplasia were selected from the group and they were classified based on the severity of the features. Surgical correction performed in each group was detailed.

Results: 3.33 percent of the 600 rhinoplasties performed in our department turned out to be cases of Binder’s syndrome. Nasal correction with loco regional autologous cartilage grafts was sufficient in mild cases. Loco-regional cartilage grafts along with costal cartilage grafts were needed for moderate and severe cases. Anterior nasal floor along with alar base augmentation was performed to achieve a proper aesthetic profile in moderate and severe cases. Post-operative results were excellent in mild and moderate cases and acceptable in severe cases.

Conclusion: Most cases of nasomaxillary hypoplasia present as mild or moderate deformity, severe hypoplasia being seen in only a few cases. During surgical reconstruction, locoregional cartilage grafts (septal and conchal) can be used extensively in mild and moderate cases without having to solely depend on costal cartilage for augmentation.

Keywords: Binder’s syndrome; classification; nasomaxillary hypoplasia; rhinoplasty