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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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. hoouse

Regional assessment, rather than HB grading, yields stricter evaluation, resulting in better prognosis and determination of grade.

This study was approved by the Ethical Committee of Kyung Hee University Hospital, and all patients provided written informed consent. House-Brackmann versus Burres-Fisch methods.

In 3 of 5 patients with synkinesis and an obligatory Grade 3 or higher in the global House-Brackmann grading system, the regional facial function was Grade 2 or better at one or more areas of the face. By continuing to browse this site you agree to us using cookies as described in our “standard cookie policy”. Agreement between the Facial Nerve Grading System 2. Alternate grading systems include the “Yanagihara” and “Sunnybrook” scales [ 23 ]. 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.


In patients with variable facial weakness, the single House-Brackmann score did not fully communicate their facial function. The management of peripheral facial nerve palsy: In addition we include a description of segmental weakness zone-specific informationchanges in the facial soft tissues and synkinesis.

The motor function of the facial nerve can be rapidly and conveniently categorized into six HB grades. We had hypothesized that patients with Bell’s “paresis” would completely recover within 3 months [ 10 ], and we therefore regarded 3 months as the minimum period for determining patient prognosis.

On the FNGS 2. Further, the single grade did not always correlate with the best or worst function along the four facial regions. Second, the final follow-up was performed 3 months after treatment; however, this period is too short to make decisions on facial paralysis.

House Brackmann

Grading of facial palsy. In addition, a longer follow-up 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. In other studies, hrackmann observers watch videos of patients [ 491112 ].

In contrast, one patient showed full recovery on the FNGS 2. In conclusion, FNGS 2.

Among them, one patient scored 2 points in the brow region, and the other four scored 2 points in the oral region in FNGS 2. Although not identical, as the evaluation criteria differ for the “regional” grading system and FNGS 2.


Facial nerve dysfunction facial paralysis manifests in various symptom patterns. The HB grading system, however, has various shortcomings, including its inability to accurately evaluate synkinesis and contracture. When compared with HB grading, the kappa value was 0. Since the main objective of this study was to assess the difference between the two facial nerve grading systems, gradinv follow-up period itself was not a huge limitation.

However, the time required for FNGS 2. 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.

House Brackman Scale – ANZ Journal of Surgery

We assumed that the difference in grade I may reflect inter-examiner variation. Prospective study of 38 patients with facial palsy who demonstrated differential facial function. Facial nerve grading system.

The reasons for the disagreement over grade I outcomes between the two scales remains unclear. Clinical and Experimental Otorhinolaryngology ; 6 3: However, it has been difficult for this system to replace HB grading.

No potential conflict of interest relevant to this article was reported. Agreement between the traditional global score and the regional scores was analyzed.