Binder Syndrome

What is Binder syndrome?

Binder syndrome — also known as maxillonasal dysplasia or nasomaxillary hypoplasia — is a rare congenital condition, which means that a baby is born with it. This condition causes an underdeveloped midface and nose, which can appear as a flattened nose and shorter upper jaw.

What are the symptoms of Binder syndrome?

The main sign of Binder syndrome is a flattened midface. This may mean that your child will have:

  • an underdeveloped or recessed upper jaw (hypoplasia), which makes the lower jaw look like it’s sticking out
  • misaligned teeth
  • a flat nose or nasal bridge
  • nostrils that are shaped like half-moons or commas

What causes Binder syndrome?

We don’t yet know for certain what causes Binder syndrome. In many cases, it appears to occur spontaneously, but genetic factors may play a role.

How is Binder syndrome diagnosed?

Your child’s doctor will diagnose Binder syndrome based on:

How is Binder syndrome treated?

Some children with Binder syndrome may only need orthodontic treatment such as braces to straighten their teeth. Others may need orthognathic surgery for some jaw abnormalities. This approach consists of changing the positions of the maxilla (the bone that forms the upper jaw), the mandible (the bone that forms the lower jaw), and the alveolar bones (the bones that support the tooth sockets).

For some jaw abnormalities, your child may need a procedure called a Le Fort I or II osteotomy. This involves reconstructing the jaw to address the malocclusion (overbite) of the teeth, as well as the flattened appearance of the midface. We may also recommend nasal reconstruction, which can include cartilage grafting and procedures to address narrowed nasal passages.

Our approach to Binder syndrome

The experienced team of clinicians in the Department of Plastic and Oral Surgery at Boston Children’s Hospital includes neurosurgeons, plastic surgeons, oral and maxillofacial (jaw) specialists, dentistry professionals, psychologists, and social workers. Together, we develop a customized care plan for your child based on their specific needs.