A comparison of facial nerve grading systems.

Abstract

This study aimed to compare a computerized tool to standard objective clinical scales for global and zone-specific assessment of facial nerve function. This was a retrospective review of 77 patients with facial paralysis who underwent facial videography. Videos were independently scored by 3 facial nerve specialists using the House-Brackmann Scales (HBI and HBII). Digital scoring was performed with Facogram software. Scores were recorded and compared using intraclass and Pearson (r) correlations. Interobserver correlation was high with HBII, with overall scores in excellent agreement (intraclass correlation range, 0.78-0.95; P ≤ 0.0001). There were strong correlations between Facogram and HBII (r ≥ 0.67, P ≤ 0.0001) and strong intraobserver correlations between HBI and HBII (r ≥ 0.71, P ≤ 0.0001). The HBII required more clinician time [mean (SD), 72 (21) seconds per case], compared with Facogram, which did not require any clinician time. An automated, zone-specific facial analysis tool can eliminate clinician subjectivity and allow standardized assessment of facial paralysis.