Clinical Rhinology

Register      Login

VOLUME 13 , ISSUE 1 ( January-April, 2020 ) > List of Articles


Binder's Syndrome: A Rare Case Report

Divya Vaid, Deepika Vajpayee, Shilpa Rafeek, Dhirendra Suman, Lakshmi Vaid

Citation Information : Vaid D, Vajpayee D, Rafeek S, Suman D, Vaid L. Binder's Syndrome: A Rare Case Report. Clin Rhinol An Int J 2020; 13 (1):30-34.

DOI: 10.5005/jp-journals-10013-1363

License: CC BY-NC 4.0

Published Online: 01-04-2020

Copyright Statement:  Copyright © 2020; The Author(s).


Background: Binder's syndrome or maxillonasal dysplasia is a rare developmental anomaly affecting the anterior maxillary region and nasal complex. Its causes are unclear and it is characterized by an extremely flat nose and retruded midface with a concave profile. Case description: We describe here a case of an 18-year-old male patient who presented with external nasal deformity since birth. On examination, the patient had classical features of the condition described by von Binder in 1962. Using costal cartilage graft, the nasal dorsum and the premaxilla were augmented by combined oral vestibular and external rhinoplasty approach. A brief review of the anomaly and the proposed treatment options in accordance with the age and the degree of malformation has been discussed. Conclusion: Satisfactory correction of the maxillonasal deformity, to achieve pleasing esthetics without functional limitations, is a challenge for surgeons. Clinical significance: This case report highlights the importance of correctly diagnosing patients suffering from Binder's syndrome (maxillonasal hypoplasia) and providing them with appropriate management. If clinicians miss this diagnosis, the desired surgical outcomes may not be achieved by rhinoplasty only without premaxillary augmentation.

  1. Jackson IT, Moos KF, Sharpe DT. Total surgical management of binder's syndrome. Ann Plast Surg 1981;7(1):25–34. DOI: 10.1097/00000637-198107000-00004.
  2. Quarrell OW, Koch M, Hughes HE. Maxillonasal dysplasia (binder's syndrome). J Med Genet 1990;27(6):384–387. DOI: 10.1136/jmg.27.6.384.
  3. Jain U, Thakur G, Kallury A. Binder's syndrome. BMJ Case Ref 2011;2011(oct11 1):bcr0820114665. DOI: 10.1136/bcr.08.2011.4665.
  4. Babu SG, Rao KAHT, Shetty SR, et al. Binder's syndrome. Online J Health Alled Scs 2011;10(2):20.
  5. Bhatt YC, Vyas KA, Tandale MS, et al. Maxillonasal dysplasia (Binder's syndrome) and its treatment with costal cartilage graft: a follow-up study. Indian J Plast Surg 2008;41(2):151–159. DOI: 10.4103/0970-0358.44925.
  6. Horswell BB, Holmes AD, Barnett JS, et al. Maxillonasaldysplasia (Binder's syndrome): a critical review and case study. Oral Maxillofac Surg 1987;45(2):114–122. DOI: 10.1016/0278-2391(87)90401-0.
  7. Ortiz Monasterio F, Molina F, McClintock JS. Nasal correction in Binder's syndrome: the evolution of a treatment plan. Aesthet Plast Surg 1997;21(5):299–308. DOI: 10.1007/s002669900129.
  8. Gorlin R, Pindborg JJ, Cohen Jr M. Maxillonasal dysplasia (Binder syndrome). Syndromes of the head and neck. 2nd ed., New York: McGraw-Hill; 1976.
  9. Olow-Nordenram M, Valentin J. An etiologic study of maxillonasal dysplasia: Binder's syndrome. Scand J Dent Res 1988;96(1):69–74. DOI: 10.1111/j.1600-0722.1988.tb01410.x.
  10. Ferguson JW, Thompson RPJ. Maxillonasal dysostosis (Binder syndrome): a review of the literature and case reports. Eur J Orthod 1985;7(2):145–148. DOI: 10.1093/ejo/7.2.145.
  11. Mudgade DK, Patel JS, Nasiruddin M, et al. Binder's syndrome: report of two cases. J Indian Acad Oral Med Radiol 2014;26(2):196–199. DOI: 10.4103/0972-1363.143701.
  12. Converse JM, Horowitz SL, Valauri AJ, et al. The treatment of nasomaxillary hypoplasia: a new pyramidal nasoorbital maxillary osteotomy. Plast Reconstr Surg 1970;45(6):527–535. DOI: 10.1097/00006534-197006000-00001.
  13. Olow-Norderam M, Radberg CT. Maxillonasal dysplasia (Binder syndrome) and associated malformations of the cervical spine. Acta Radiol Diagn 1984;25(5):353–360. DOI: 10.1177/028418518402500501.
  14. Delaire J, Tessier P, Tulasne JF, et al. Clinical and radiological aspects of maxillonasal dysostosis (Binder syndrome). Head Neck Surg 1980;3(2):105–122. DOI: 10.1002/hed.2890030205.
  15. Munro IR. Maxillonasal dysplasia (Binder's syndrome). Plas Reconst Surg 1979;41:536–542.
  16. Tessier P, Tulasne JF, Delaire J, et al. Therapeutic aspects of maxillonasal dysostosis (Binder syndrome). Head Neck Surg 1981;3(3):207–215. DOI: 10.1002/hed.2890030308.
  17. Holmstrom H. Surgical correction of the nose and midface in maxillonasal dysplasia (Binder's syndrome). Plast Reconstr Surg 1986;78(5):568–580. DOI: 10.1097/00006534-198611000-00002.
  18. Ragnell A. A simple method of reconstruction in some cases of dish-face deformity. Plast Reconstr Surg 1952;10(4):227–237. DOI: 10.1097/00006534-195210000-00002.
  19. Holmstrom H, Kahnberg KE. Surgical approach in severe cases of maxillo nasal dysplasia (Binder's syndrome). Swed Dent J 1988;12(1–2):3–10.
  20. Obwegeser HL. Surgical correction of small or retro displaced maxillae. The “dish-face” deformity. Plast Reconstr Surg 1969;43(4):351–365.
  21. Henderson D, Jackson IT. Naso-maxillary hypoplasia-the LeFortII osteotomy. Br J Oral Surg 1973;11(2):77–93. DOI: 10.1016/0007-117X(73)90022-X.
  22. Deshpande SN, Juneja MH. Binder's syndrome (maxillonasal dysplasia) different treatment modalities: Our experience. Indian J Plast Surg 2012;45(1):62–66. DOI: 10.4103/0970-0358.96588.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.