House-Brackmann facial nerve grading system
Grade I - Normal Normal facial function in all areas Grade II - Slight Dysfunction Gross: slight weakness noticeable on close inspection; may have very slight synkinesis At rest: normal symmetry and tone Motion: forehead - moderate to good function; eye - complete closure with minimum effort; mouth - slight asymmetry. Grade III - Moderate Dysfunction Gross: obvious but not disfiguring difference between two sides; noticeable but not severe synkinesis, contracture, and/or hemi-facial spasm. At rest: normal symmetry and tone Motion: forehead - slight to moderate movement; eye - complete closure with effort; mouth - slightly weak with maximum effort. Grade IV - Moderate Severe Dysfunction Gross: obvious weakness and/or disfiguring asymmetry At rest: normal symmetry and tone Motion: forehead - none; eye - incomplete closure; mouth - asymmetric with maximum effort. Grade V - Severe Dysfunction Gross: only barely perceptible motion At rest: asymmetry Motion: forehead - none; eye - incomplete closure; mouth - slight movement Grade VI - Total Paralysis No movement Reference House JW, Brackmann DE. Facial nerve grading system. Otolaryngol. Head Neck Surg 1985; 93: 146–147. |
