Surgical Treatment for Patients With Binder Syndrome, Clinical Features and Associated Symptoms: A Systematic Review.

BACKGROUND: Binder syndrome is a rare congenital malformation of the midface. Since 1990, no systematic review has been conducted on this condition. Our study aims to review and collect the surgical treatment options available for correcting nasomaxillary dysplasia and the information available in the international literature on Binder syndrome and associated symptoms. METHODS: This systematic literature review was registered in the PROSPERO (International Prospective Register of Systematic Reviews) database. Systematic literature searches were performed in Medline, Scopus, the Cochrane Library, and Web of Science databases. Study quality assessment was performed according to recommendations from the Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy. RESULTS: The authors identified 200 articles from our database research. One hundred sixty-nine articles were excluded after the title and abstract screening. Seven articles were excluded after screening the full text. In total, 24 clinical studies were included: 14 studies aim to describe a surgical option and 10 articles treat information about Binder syndrome or associated features. Most of the studies (12/14 studies) performed rhinoplasties to treat nasomaxillary dysplasia. The 2 other articles evaluated maxillary osteotomy techniques. Only 3 articles compared the results obtained from different surgical techniques. CONCLUSIONS: No optimal surgical treatment plan has been developed, even if numerous surgical options are available. Etiology is still uncertain.

Three-Dimensional Cephalometric Landmarking and Frankfort Horizontal Plane Construction: Reproducibility of Conventional and Novel Landmarks.

In some dentofacial deformity patients, especially patients undergoing surgical orthodontic treatments, Computed Tomography (CT) scans are useful to assess complex asymmetry or to plan orthognathic surgery. This assessment would be made easier for orthodontists and surgeons with a three-dimensional (3D) cephalometric analysis, which would require the localization of landmarks and the construction of reference planes. The objectives of this study were to assess manual landmarking repeatability and reproducibility (R&R) of a set of 3D landmarks and to evaluate R&R of vertical cephalometric measurements using two Frankfort Horizontal (FH) planes as references for horizontal 3D imaging reorientation. Thirty-three landmarks, divided into "conventional", "foraminal" and "dental", were manually located twice by three experienced operators on 20 randomly-selected CT scans of orthognathic surgery patients. R&R confidence intervals (CI) of each landmark in the -x, -y and -z directions were computed according to the ISO 5725 standard. These landmarks were then used to construct 2 FH planes: a conventional FH plane (orbitale left, porion right and left) and a newly proposed FH plane (midinternal acoustic foramen, orbitale right and left). R&R of vertical cephalometric measurements were computed using these 2 FH planes as horizontal references for CT reorientation. Landmarks showing a 95% CI of repeatability and/or reproducibility > 2 mm were found exclusively in the "conventional" landmarks group. Vertical measurements showed excellent R&R (95% CI < 1 mm) with either FH plane as horizontal reference. However, the 2 FH planes were not found to be parallel (absolute angular difference of 2.41°, SD 1.27°). Overall, "dental" and "foraminal" landmarks were more reliable than the "conventional" landmarks. Despite the poor reliability of the landmarks orbitale and porion, the construction of the conventional FH plane provided a reliable horizontal reference for 3D craniofacial CT scan reorientation.

Augmentation Genioplasty Using a Third Molar as a Bone Graft: An Alternative Surgical Technique.

PURPOSE: Augmentation genioplasty corrects vertical chin deficiency. To stabilize the synthesis and to allow ossification, a biomaterial prop is necessary. Third molars are frequently removed during orthognathic surgery and provides good material used as autogenous grafts. SURGICAL TECHNIQUE: This article describes the surgical technique of an augmentation genioplasty using a third molar as a prop biomaterial. Results are stable in time. This technique presents no risk of infection and is less invasive than other autogenous bone graft. CONCLUSIONS: third molar can be used as a prop biomaterial in augmentation genioplasty.

[Benef its of innovation in orthognathic surgery for OSA]. / Place de l'innovation dans la chirurgie orthognathique du syndrome d'apnées obstructives du sommeil.

Obstructive sleep apnea (OSA) is a common, multifactorial disease resulting in high morbidity and mortality. Gold standard treatment is nocturnal positive airway pressure. Maxillomandibular advancement is a surgical technique used to treat obstructive sleep apnea. Development of guided surgery has modified patient care in cases of maxillomandibular dysgnathia. Two case reports illustrate the impact of new technologies on surgical treatment of this condition. New technologies such as the recent development of surgical guides help surgical management.

Rhabdomyosarcoma and rhabdomyoma associated with nevoid basal cell carcinoma syndrome: Local treatment strategy.

This article presents the case of a child presenting with a rhabdomyosarcoma associated with a fetal rhabdomyoma in the setting of nevoid basal cell carcinoma syndrome. Oncologic strategy is discussed.