Facial nerve grading system

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The House–Brackmann score is a score to grade the degree of nerve damage in a facial nerve palsy. The measurement is determined by measuring the upwards (superior) movement of the mid-portion of the top of the eyebrow, and the outwards (lateral) movement of the angle of the mouth.

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The HB grading system, which was chosen as the standard by the FND Committee of the American Academy in , remains the most widely used facial nerve grading system. The motor function of the facial nerve can be rapidly and conveniently categorized into six HB grades.

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Facial nerve grading system. House JW, Brackmann DE. PMID: [Indexed for MEDLINE] Publication Types: Research Support, Non-U.S. Gov't; MeSH terms. Facial Nerve/physiopathology* Facial Paralysis/classification* Facial Paralysis/physiopathology; Humans.


Facial Grading System Video demonstration. Dr. Nedzelski demonstrating the Sunnybrook Facial Grading System. Please note that this video is a videotape transfer. It is a large video file that may take up to 30 seconds to start playing depending on your internet connection speed. A, A patient with acute right-sided flaccid facial paralysis from Ramsay Hunt syndrome receives a score of 20 for resting facial symmetry on the Sunnybrook Facial Grading System (FGS).
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A comprehensive, accurate, and valid system for reporting results of facial nerve surgery and disease is needed. This study describes and statistically analyzes eight currently available systems.

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The addition of subscores within grades 3 and 4 may be useful in defining outcomes after facial nerve grafts. Additional study of the grading scale will be necessary to examine this issue. Bilateral paralysis is problematic to grade when a grading system is based on direct comparison with the contralateral side. The Nottingham system offers a more objective but easy-to-use facial nerve grading system that has been demonstrated to be valid and that would be easy for the average practitioner to adopt.

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Objective: To present an updated version of the original Facial Nerve Grading Scale (FNGS), commonly referred to as the House-Brackmann scale. Study Design: Controlled trial of grading systems using a series of 21 videos of individuals with varying degrees of facial paralysis.

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