House–Brackmann score
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 0.25 cm movement, up to a maximum of 1 cm. The scores are then added together, to give a number out of 8.[1] The score predicts recovery in those with Bell's palsy.[2]
The score carries the name of the Dr John W. House and Dr Derald E. Brackmann, otolaryngologists in Los Angeles, who first described the system in 1985.[1] It is one of a number of facial nerve scoring systems, such as Burres-Fisch, Nottingham, Sunnybrook,[3] and Yanagihara.[4] Of these, the Notthingham scale has been identified as possibly being easier and more reproducible.[3] A modification of the original House–Brackmann score, called the "Facial Nerve Grading Scale 2.0" (FNGS2.0) was proposed in 2009.[4]
| Grade | Description | Measurement | Function % | Estimated function % |
|---|---|---|---|---|
| I | Normal | 8/8 | 100 | 100 |
| II | Slight | 7/8 | 76–99 | 80 |
| III | Moderate | 5/8–6/8 | 51–75 | 60 |
| IV | Moderately severe | 3/8–4/8 | 26–50 | 40 |
| V | Severe | 1/8–2/8 | 1–25 | 20 |
| VI | Total | 0/8 | 0 | 0 |
References
- ^ a b House JW, Brackmann DE (1985). "Facial nerve grading system". Otolaryngol Head Neck Surg. 93: 146–147. PMID 3921901.
- ^ Danner CJ (June 2008). "Facial nerve paralysis". Otolaryngol. Clin. North Am. 41 (3): 619–32. doi:10.1016/j.otc.2008.01.008. PMID 18436002.
- ^ a b Kang TS, Vrabec JT, Giddings N, Terris DJ (September 2002). "Facial nerve grading systems (1985-2002): beyond the House-Brackmann scale". Otol. Neurotol. 23 (5): 767–71. PMID 12218632.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ a b Vrabec JT, Backous DD, Djalilian HR; et al. (April 2009). "Facial Nerve Grading System 2.0". Otolaryngol Head Neck Surg. 140 (4): 445–50. doi:10.1016/j.otohns.2008.12.031. PMID 19328328.
{{cite journal}}: Explicit use of et al. in:|author=(help)CS1 maint: multiple names: authors list (link)
External links
- The visual appearance of the defect is described here