Facial nerve grading system

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Facial nerve dysfunction (facial paralysis) manifests in various symptom patterns. To objectively describe facial function, clinicians use a number of standardised scales - the most common being the House-Brackmann facial nerve grading system. Symptoms of facial nerve injury may vary due to age, facial anatomy and the extent of nerve-damage.

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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; HumansCited by:

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Facial Nerve Grading System. This study describes and statistically analyzes eight currently available systems for reliability, validity, and ease of use. They are divided into three grading categories: gross scales, regional systems, and specific scales. Botman and Jongkees, May, and Peitersen have proposed five-point gross scales.


The House Brackmann scale is the most commonly used facial function grading system in clinical practice in delineating between symptoms and nerve damage. The overall grading system is described in the following table: Grade I - Normal Normal facial function in all. *Please note: This scale is used to evaluate facial paralysis at the nerve trunk, and is not a descriptive scale to describe injury to specific distal facial nerve branches. First degree: nystagmus on gaze toward the quick component. Second degree: nystagmus on gaze toward the quick component and on .
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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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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. Each reference point scores 1 point for each cm movement, up to a maximum of 1 cm. 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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Facial Grading System publications. Otolaryngol Head Neck Surg. Dec; (6): Coulson SE, Croxson GR, Adams RD, O’Dwyer NJ. Reliability of the “Sydney,” “Sunnybrook,” and “House Brackmann” facial grading systems to assess voluntary movement and synkinesis after facial nerve paralysis. Otolaryngol Head Neck Surg. Apr; (4): Invited article Facial Nerve Grading System Results The intraobserver and interobserver agreement was high among the original and revised scales. Nominal improvement is seen in percentage of exact agreement of grade and reduction of instances of examiners differing by more then one grade when using FNGS Cited by:

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The aim of the present study was to verify the interrater reliability and the interscale validity Facial nerve grading system of this simplified grading system. Interrater reliability Subjective scale Study design: Scale validation study based on a prospective cohort. The H-B grading system has marked limitations: it has only 6 possible grades, and it does not provide detailed informations about specific dysfuntional areas in the face. There is no specific evaluation of synkinesis (aberrant linking of movements which is a sequelae of moderate to severe facial nerve .
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