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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House–Brackmann score – Wikipedia

These differences are likely due to the more detailed analysis on the FNGS 2. Had patients been evaluated by two or more barckmann, we could have calculated interobserver differences, enhancing the value of our results. When compared with HB grading, the kappa value was 0.

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For both the eyebrow and oral commisure movement, 1 point is assigned for every 0. These problems may be overcome and long term results obtained by a multi-center study with larger numbers of patients. We found that the brackmaann of complete recovery was lower on the FNGS 2.

Reliability of the “Sydney”, “Sunnybrook”, and “House Brackmann” facial grading systems to assess voluntary movement and synkinesis after facial nerve paralysis.


This system evaluates movements of 10 facial muscles, assigning each a score of points, resulting in a maximum score of 40 points.

House–Brackmann score

The ICC between the two scales was 0. There is no specific evaluation of synkinesis aberrant linking of movements which is a sequelae of moderate to severe facial nerve damage. Our previous studies found that observing the electrical response of specific facial muscles provided reasonable correlation with the prognosis of electroacupuncture treatment.

Previously, evaluators focused primarily on whether the eye closed during different degrees of paralysis of each branch of the facial nerve [ 5 ]. This is an open-access article distributed under the terms of nouse Creative Commons Attribution Non-Commercial License http: 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 of paralysis.

House and Dr Derald E.

House-Brackman Scale (facial nerve palsy)

Thus, this scale cannot be used for systematic regional assessment and is limited in determining prognosis. The scores for each structure housd added together to give the House-Brackmann score. On the FNGS 2. Clinical and Experimental Otorhinolaryngology ; 6 3: 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. In theory, normal is normal no matter what scale is used.

The motor function of the facial nerve can be rapidly and conveniently categorized into six HB grades.

House–Brackmann Scale – Physiopedia

Facial nerve grading system. The House-Brackmann grading system has been found to be of high reliability, however examination of individual grades revealed wide variations between trained observers.


The reasons for the disagreement over grade I outcomes between the two scales remains unclear. The H-B grading system has marked limitations: The HB grading system, however, has various shortcomings, including its inability to accurately evaluate synkinesis and contracture.

The content on or accessible through Physiopedia is for informational purposes only. We therefore analyzed the rate of agreement of the two scales and confirmed the properties and usefulness of FNGS 2. Prediction of nonrecovery in Bell’s palsy using Sunnybrook grading.

Toggle navigation p Physiopedia. 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. Although not identical, as the evaluation criteria differ for the “regional” grading system and FNGS 2. Skip to search form Skip to main content.

Regional assessments using the HB grading system may enhance communication between researchers [ 5 ].

Development of a sensitive clinical facial grading system. In other studies, many observers watch videos of patients uouse 491112 ]. To minimize these shortcomings, studies have explored the Yanagihara and Sunnybrook grading systems.

The scale is used to vrackmann the severity of facial nerve dysfunction in people with facial palsy. Agreement between the Sunnybrook, House-Brackmann, and Yanagihara facial nerve grading systems in Bell’s palsy. The management of peripheral facial nerve palsy: Thus, the FNGS 2.

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