House-Brackman Scale facial nerve palsy The House-Brackmann scale ranges between I normal and VI no movement. Grade I Normal symmetrical function. 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 scale and, four appraisers felt that training is important for the House necessário treinamento prévio; na escala de House & Brackmann.

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Agreement between the Facial Nerve Grading System 2. Description of House-Brackmann grades. The House-Brackmann grading system has been found to be of high reliability, brackmqnn examination of individual grades revealed wide variations between trained observers.

House–Brackmann score

Had patients been evaluated by two or more examiners, we could have calculated interobserver differences, enhancing the value of our results. The motor function of the facial nerve can be rapidly and conveniently categorized into six Sdale grades. 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 grading systems well. Toggle navigation p Physiopedia. A method of selecting acupoints for acupuncture treatment of peripheral facial paralysis by thermography.

However, it has been difficult for this system to replace HB grading. These differences are likely due to the more detailed analysis on the FNGS 2. Search the site Search. Showing of 18 references.

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 ]. 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.


Although not identical, as the evaluation criteria differ for the “regional” grading system and FNGS 2. We found that 43 patients Physiopedia is not a substitute for professional advice or expert medical services from a qualified healthcare provider. When refering to evidence in academic writing, you should always try to reference the primary original source. Retrieved from ” https: Contents Editors Categories Share Cite. A comparison of facial nerve grading systems.

House–Brackmann Scale – Physiopedia

If you believe that this Physiopedia article is the primary source for the information you are refering to, you can use the button below to access a related citation statement. Facial nerve grading system. Prediction of nonrecovery in Bell’s palsy using Sunnybrook grading.

Introduced inthe Yanagihara system is a regional scale most frequently used in Japan. The reasons for the disagreement over grade I outcomes between the two scales remains unclear. House and Dr Derald E. A comparison and conversion table of ‘the House-Brackmann facial nerve grading system’ and ‘the Yanagihara grading system’. Of these, 31 patients had Bell palsy on the right side and 29 on the left side.

Facial paralysis Histopathologic Grade Bell Palsy.

House-Brackman Scale (facial nerve palsy)

Scald response grading versus House-Brackmann scale for evaluation of facial nerve injury after Bell’s palsy: Grade V Motion barely perceptible Incomplete eye closure, slight movement corner mouth Synkinesis, contracture, and spasm usually absent. But its main limitation for physiotherapists is that it is not sensitive enough to detect the small changes that occur during a course of rehabilitation.

Alternate grading systems include the “Yanagihara” and “Sunnybrook” scales [ 23 ].

To determine the clinical significance of the House-Brackmann facial nerve grading scale HBFNGS in the setting of brqckmann function along the branches of the facial nerve.


To date, however, few studies have compared these two grading systems in real patients and confirmed whether FNGS 2. Thus, the FNGS 2.

This study had several limitations. Prospective study of 38 patients with facial palsy who demonstrated differential facial function. Regional assessments using the HB grading system may enhance communication between researchers [ 5 ]. No potential conflict of interest relevant to this article was reported.

House–Brackmann score – Wikipedia

First, all patients were evaluated on both systems by a single examiner. This system is sensitive in assessing changes in facial recovery [ 2 ] and has been reported highly reliable, with intra- and inter-rater reliability similar for beginners and experts [ 9 ].

In other studies, many observers watch videos of patients [ 491112 ]. For objectivity, measurements should be made on both the normal and the affected side.

In contrast, one patient showed full recovery on the FNGS 2. Second, the final follow-up was performed brackmsnn months after treatment; however, this period is too short to make decisions on facial paralysis.

None of the patients received an antiviral agent. The maximum score obtainable is 8, if both structures move the full 1cm. 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. Facial Nerve Grading System 2. Another limitation of this study was that we did not evaluate patients whose paralysis was due to other causes such as external injury or surgery.

The management of peripheral facial nerve palsy: