The House–Brackmann score is a score to grade the degree of nerve damage in a facial nerve A modification of the original House–Brackmann score, called the “Facial Nerve Grading Scale ” (FNGS) was proposed in KEYWORDS. Facial paralysis;. Evaluation;. Scales;. Classification; necessário treinamento prévio; na escala de House & Brackmann, . Assessment of facial movement according to House & Brackmann (). Grade. House-Brackman Scale facial nerve palsy The House-Brackmann scale ranges between I normal and VI no movement. Grade I Normal symmetrical function.

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Although unquantifiable sensory deficits cannot be evaluated, detailed regional assessments of the brow, eye, nasolabial fold, and oral regions are possible, as are assessments of movement at any point grdaing paralysis.

Significance of House-Brackmann facial nerve grading global score in the setting brackmamn differential facial nerve function. However, the time required for FNGS 2. All statistical analyses were performed using SPSS ver. Introduced inthe Yanagihara system is a regional scale most frequently used in Japan.

Facial nerve grading system.

Our site uses cookies to improve your experience. First, all patients were evaluated on both systems by a single examiner.

In conclusion, FNGS 2. The regional assessment capacity of the FNGS 2.

House Brackman Scale – ANZ Journal of Surgery

To determine the clinical significance of the House-Brackmann facial nerve grading faciwl HBFNGS in the setting of differential function along the branches of the facial nerve. Plastic and Reconstructive Surgery, All rights reserved. Although this possibility cannot be excluded, we believe that the principal reason for the difference between the scales is the ambiguity of HB grading in most cases, preventing accurate analysis without strict regional assessment [ 4 ].


Agreement between the Facial Nerve Grading System 2. Facial Nerve Grading System 2. Grade I at 3 months was considered the standard for complete recovery for evaluation of prognosis. The ICC between the two scales was 0. bracmann

This is especially applicable when evaluating, for example, the effects of antiviral agents on prognosis in patients with Bell palsy. Use of the two scales in patient prognosis Recovery status was evaluated at 3 months, with grade I of both grading systems defined as complete recovery. Patients were also evaluated by both scales at each follow-up time point, with each patient evaluated at least twice for both systems by an otolaryngologist who understood both fadial systems well.

Grade II Slight weakness noticeable only on close inspection Complete eye closure with minimal effort Slight asymmetry of smile with maximal effort Synkinesis barely noticeable, contracture, or spasm absent.

It is a widely accepted system, simple, sensitive, accurate and reliable – grading facial function in six steps from normal HB I to total paralysis HB VI. Our more systematic regional assessment confirmed that the FNGS 2. Frequent patient concerns relate to brow position, movement abnormalities, eyelid closure gfading, inability to smile, mid-facial asymmetries, poor oral function and lower lip asymmetry.

Physicians were provided with printed description of the HBFNGS and asked to report facial nerve function as a traditional global score and as a regional score based on the House-Brackmann scale for the forehead, eye, nose, and mouth. House-Brackmann HB is one of several analysis tools developed to quantify facial function and provide reproducible information.

Agreement between the Sunnybrook, House-Brackmann, and Yanagihara facial nerve grading systems in Bell’s palsy. We found that 43 patients A light degree of facial nerve weakness may only be visible as subtle asymmetries following repeated and exhausting muscle function, whereas severe dysfunction can be easily recognised even at rest. You can find out more about our use of cookies in our “standard cookie policy”including instructions on how to reject and delete cookies if you wish to do so.


Reliability of the Sunnybrook Facial Grading System by novice users. Many of these symptoms will change over time, for example following a spontaneous recovery of nerve function or as a result of different therapeutic modalities i.

House Brackmann

Proper assessment of complete recovery requires a stricter assessment system. Agreement between the grading systems and their evaluation of patient prognosis were calculated by ggading correlation coefficient ICCSpearman correlation analysis SCCand overall percentage agreement. Current issue Free content Submit an article. This study was approved by the Ethical Committee of Kyung Hee University Hospital, and all patients provided written informed consent.

Grading of facial palsy. Grade I Gradijg symmetrical function Grade II Slight weakness noticeable only on close inspection Complete eye closure with minimal effort Slight asymmetry of smile with maximal effort Synkinesis barely noticeable, contracture, or spasm absent Grade III Obvious weakness, but not disfiguring May not be able to lift eyebrow Complete eye closure and strong but asymmetrical mouth movement Obvious, but not disfiguring synkinesis, mass movement or spasm Grade IV Obvious disfiguring weakness Inability to lift brow Incomplete eye closure and asymmetry of mouth with maximal effort Severe synkinesis, mass movement, spasm Grade V Motion barely perceptible Incomplete eye closure, slight movement corner mouth Synkinesis, contracture, and spasm usually absent Grade VI No movement, loss of tone, no synkinesis, contracture, or spasm Reference House JW, Brackmann DE.

Results The overall intraclass correlation coefficient ICC was 0.