The authors have had satisfactory results in two cases of Binder´s syndrome by using a combined Le Fort Land II osteotomy with a calvarial bone graft in the nasal dorsum and perinasal fossa.
A combined Le Fort I & II osteotomy was performed through paranasal and buccal vestibular incisions. We were able with a Le Fort I advancement to convert a class M occlusion to a normal occlusion and a Le Fort II advancement to correct the nasomaxillary hypoplasia without disrupting the dental arch. The paranasal incision, which remained inconspicous, had several advantages, not only is the Le Fort II osteotomy and augmentation of the nasal dorsum and lateral a wall, more easily performed, but also through a V-Y advancement, the shortage of soft nasal tissue is eliminated.
However, we observed a marked.resorption of the nasal bone graft due to excessive skin tension on the nasal dorsum, so consequently, a secondary augmentation with a silicone implant was needed.
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