Good correlation between original and modified House Brackmann facial grading systems.

Area of Science:

• Otolaryngology
• Facial Nerve Surgery
• Clinical Outcomes Assessment

Background:

• Facial function assessment historically faced reporting variability.
• The original House-Brackmann scale (1985) improved standardization but had limitations.
• Limitations included exclusion of synkinesis and segmental weakness insensitivity.

Purpose of the Study:

• To evaluate the agreement between the original House-Brackmann scale and its recently revised version.
• To compare the scoring time and interobserver reliability of both scales.

Main Methods:

• Prospective clinical trial involving 50 new facial paralysis patients.
• Standardized facial videography during facial movements.
• Scoring by three independent facial nerve clinicians, tracking time and calculating interobserver correlations.

Main Results:

• High interobserver correlation was observed for both the original and modified House-Brackmann scales.
• Excellent agreement in overall scores between the two scales (0.1 ± 0.5 difference, no statistical significance).
• The modified scale required significantly more time for scoring (120s ± 20s vs. 30s ± 10s, P < .001).

Conclusions:

• Substantial grading correlation exists between the original and modified House-Brackmann scales.
• The modified scale's increased scoring time is attributed to detailed zonal and synkinesis assessments.
• The revised scale offers enhanced detail at the cost of increased assessment duration.