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Facial nerve grading systems (1985-2002): beyond the House-Brackmann scale
Thomas S Kang1, Jeffrey T Vrabec, Neil Giddings
1Division of Otolaryngology/Head and Neck Surgery, Stanford University Medical Center, California, USA.
Summary
New facial nerve function evaluation methods aim to improve upon the subjective House-Brackmann scale. The Nottingham system offers a more objective and user-friendly alternative for clinical practice.
Area of Science:
- Neurology
- Otolaryngology
- Medical assessment tools
Background:
- The House-Brackmann scale is a widely used but subjective method for assessing facial nerve function.
- Limitations in precision and ease of use necessitate the development of improved facial nerve grading systems.
Purpose of the Study:
- To review and compare novel methods for evaluating facial nerve function introduced in the last 15 years.
- To assess the objectivity and usability of new scales against the established House-Brackmann scale.
Main Methods:
- A comprehensive Medline search of English-language literature from 1983 to 2000.
- Focused selection on grading systems offering enhanced precision or ease of use.
Main Results:
- Several new facial nerve grading systems have emerged, addressing the limitations of the House-Brackmann scale.
- The Nottingham system demonstrates validity, objectivity, and ease of use, making it suitable for practitioners.
Conclusions:
- The subjectivity of the House-Brackmann scale has driven the development of more objective and user-friendly alternatives.
- The Nottingham system presents a promising, valid, and practical option for facial nerve evaluation, warranting further systematic assessment for widespread adoption.