| House–Brackmann score | |
| Purpose: | measure degree of damage in facial nerve palsy |
The House–Brackmann score is a score to grade the degree of nerve damage in a facial nerve palsy. The measurement is determined by measuring the upwards (superior) movement of the mid-portion of the top of the eyebrow, and the outwards (lateral) movement of the angle of the mouth. Each reference point scores 1 point for each 0.25 cm movement, up to a maximum of 1 cm. The scores are then added together, to give a number out of 8.[1] The score predicts recovery in those with Bell's palsy.[2]
The score carries the name of the Dr John W. House and Dr Derald E. Brackmann, otolaryngologists in Los Angeles, California, who first described the system in 1985.[1] It is one of a number of facial nerve scoring systems, such as Burres-Fisch, Nottingham, Sunnybrook, and Yanagihara. Of these, the Nottingham scale has been identified as possibly being easier and more reproducible.[3] A modification of the original House–Brackmann score, called the "Facial Nerve Grading Scale 2.0" (FNGS2.0) was proposed in 2009.[4]
| Grade | Description | Measurement | Function % | Estimated function % | |
|---|---|---|---|---|---|
| I | Normal | 8/8 | 100 | 100 | |
| II | Slight | 7/8 | 76–99 | 80 | |
| III | Moderate | 5/8–6/8 | 51–75 | 60 | |
| IV | Moderately severe | 3/8–4/8 | 26–50 | 40 | |
| V | Severe | 1/8–2/8 | 1–25 | 20 | |
| VI | Total | 0/8 | 0 | 0 |