House-Brackmann Grading System
Posted on 2009-05-11 03:05:30
House-Brackmann Grading System
Facial paralysis can result from trauma, infection, congenital, metabolic, neoplastic, toxic, iatrogenic, or idiopathic etiologies.
Whatever the cause, the consequences for the patient can be devastating depending on the level of facial dysfunction. Several modalities exist to clinically rate the degree of facial function; including the widely used House-Brackman classification.
HOUSE-BRACKMANN CLASSIFICATION of Facial Function
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GRADE
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CHARACTERISTICS
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I. Normal
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Normal facial function in all areas
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II. Mild Dysfunction
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Gross · Slight weakness noticeable on close inspection · May have slight synkinesis · At rest, normal symmetry and tone Motion · Forehead - Moderate-to-good function · Eye - Complete closure with minimal effort · Mouth - Slight asymmetry
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III. Moderate Dysfunction
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Gross · Obvious but not disfiguring difference between the two sides · Noticeable but not severe synkinesis, contracture, or hemifacial spasm · At rest, normal symmetry and tone Motion · Forehead - Slight-to-moderate movement · Eye - Complete closure with effort · Mouth - Slightly weak with maximum effort
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IV. Moderately Severe Dysfunction
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Gross · Obvious weakness and/or disfiguring asymmetry · At rest, normal symmetry and tone Motion · Forehead - None · Eye - Incomplete closure · Mouth - Asymmetric with maximum effort
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V. Severe Dysfunction
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Gross · Only barely perceptible motion · At rest, asymmetry Motion · Forehead - None · Eye - Incomplete closure · Mouth - Slight movement
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VI. Total Paralysis
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No movement
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BELL'S PALSY
ACOUSTIC NEUROMA
PAROTID TUMOR
SYNKINESIS
FACELIFT SURGERY
NERVE INJURY
MOBIUS SYNDROME
HEMIFACIAL MICROSMIA
PAROTID
HEMIFACIAL SPASM
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