Binder Syndrome Vs Graves’ Disease

garychleung

PIG Meeting: 11th March 2021

36 year old lady with Binder Syndrome for removal of maxillary plates

Background

  • Binder syndrome – requiring multiple maxillofacial surgeries for nasal hypoplasia
  • Recurrent sinusitis necessitating removal of maxillary plates
  • Severe OSA – AHI 79. Sinusitis making it difficult for patient to comply with CPAP
  • Graves’ Disease – normal TFT’s. Known ‘enlarged thyroid.’ Not requiring management to date.

Issues

  • Recent increase in orthopnoea and hoarse voice
  • ENT referred to endocrine – awaiting review
  • Patient very keen to proceed with ENT surgery as sinusitis is greatly affecting her QoL

Discussion

  • New symptoms likely due to sinusitis and OSA
  • Patient is unable to tolerate CPAP due to sinus discomfort
  • Progression of thyroid disease should be investigated given history

Plan

  • Repeat TFT’s and Thyroid US (if not had recently) and discuss with endocrine surgeon
  • Chase Endocrine review