I just saw my ceph xray this morning, screw placement is same as this guy's. The xray is a 2D image of both sides of the skull. It's actually 3 screws either side of the skull, but gives the illusion of 5 screws vertical.
The description indicates that a genio was performed to correct sleep apnea issues, it does not specifically say that was the only work done. Misleading, but the xray tells the full story.
That jaw was surgically moved.