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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Facial nerve grading system.

None of the patients received an antiviral agent. Facial nerve grading system. Our more systematic regional assessment confirmed that the FNGS 2. Plastic and Reconstructive Surgery, All rights reserved. These problems may be overcome and long term results obtained by a multi-center study with larger numbers of patients.

Gradinv I Normal 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.

Mean time from occurrence to treatment was 2. Grading of facial palsy. Standarised assessment of facial function House-Brackmann HB is one of several analysis hhouse developed to quantify facial function and provide reproducible information. 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.


Clinical and Experimental Otorhinolaryngology ; 6 3: In brwckmann, a longer scalee period increases the likelihood that some patients will drop out of the study, especially since patients may go elsewhere for a second opinion or seek alternative treatments. Patients with complete facial nerve paralysis House-Brackmann Grade 6 were excluded. At the Sorensen Clinic we routinely use the House-Brackmann scale to evaluate new and existing patients.

Agreement between the traditional global score and the regional scores was analyzed. Thus, this scale cannot be used for systematic regional assessment and is limited in determining prognosis. Head Neck Surg ; House-Brackmann versus Burres-Fisch methods. Of these, 31 patients had Bell palsy on the right side and 29 on the left side.

We therefore analyzed the rate of agreement of the two scales and confirmed the properties and usefulness of FNGS 2. Grade III Obvious weakness, but not disfiguring May not be able to lift eyebrow Complete gtading closure and strong but asymmetrical mouth movement Obvious, but not disfiguring synkinesis, mass movement or spasm. Facial nerve grading system.

House–Brackmann score – Wikipedia

Another limitation of this study was that we did not evaluate patients whose paralysis was due to other causes such as external injury houde surgery. In theory, normal is normal no matter what scale is used. Agreement between the grading systems and their evaluation of patient prognosis were calculated by intraclass correlation coefficient ICCSpearman correlation analysis SCCand overall percentage agreement. Frequent patient concerns relate to brow position, movement barckmann, eyelid closure issues, inability to brackmanm, mid-facial asymmetries, poor oral function and lower lip asymmetry.


Due to its simplicity and convenience, the HB grading system will be difficult to replace. Introduced inthe Yanagihara system is a regional scale most frequently used in Japan. To determine the clinical significance of the House-Brackmann facial nerve grading scale HBFNGS in the setting of differential function along the branches scsle the facial nerve.

By continuing to browse this site you agree to us using cookies as described in our “standard cookie policy”. Although not identical, as the evaluation criteria differ for the “regional” grading system and FNGS 2. HB grading has several shortcomings, including: Search the site Search. The Sunnybrook system grades paralysis by evaluating symmetry at rest and during voluntary movements, and, following a series of calculations, is used to gauge synkinesis on a point scale.

House-Brackmann HB is one of several analysis tools developed to quantify facial function and provide reproducible information. In nrackmann with variable facial weakness, the single House-Brackmann score did not fully communicate their facial function. This is especially applicable when evaluating, for example, the effects of antiviral agents on prognosis in patients with Bell palsy.

Facial nerve grading system.

Patients with facial nerve dysfunction from any cause. Moreover, among patients with incomplete recovery, grades II and III were distributed differently on the two scales. First, all patients were evaluated on both systems by a single examiner.

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.