title: Agreement between the Sunnybrook, House-Brackmann, and Yanagihara facial nerve grading systems in Bell's palsy.
abstract: OBJECTIVE
  To assess the agreement between the Sunnybrook facial nerve grading system and the House-Brackmann and Yanagihara systems.
  
  
  METHODS
  Prospective clinical facial nerve grading.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  One-hundred assessments, 94 in patients with Bell's palsy and 6 with herpes zoster.
  
  
  METHODS
  Diagnostic.
  
  
  METHODS
  Evaluation according to the weighted regional Sunnybrook system, the gross House-Brackmann system, and the unweighted regional Yanagihara system. Weighted kappa statistics was used to measure agreement between the grading systems.
  
  
  RESULTS
  The average weighted kappa value between the Sunny-brook, House-Brackmann, and Yanagihara grading systems was 0.65; kappa values increased temporally (but not statistically significantly) up to day 180. The highest agreement value, 0.72, was found between the Sunnybrook and Yanagihara grading systems. The weighted kappa value between the Sunnybrook and House-Brackmann systems was 0.59. In Sunnybrook gradings less than 63, there was an overlap between House-Brackmann scores of III to VI. Reliable conversion tables between the gross House-Brackmann system and the regional Sunnybrook and Yanagihara systems could not be established.
  
  
  CONCLUSIONS
  The Sunnybrook system scores at the same agreement level as the House-Brackmann and Yanagihara grading systems. There is an evaluative difference between the weighted regional Sunnybrook and the gross House-Brackmann systems. Substantial agreement was found between the regional Sunnybrook and Yanagihara scales. Sunnybrook grading is easy and quick. By adding objective measurements and additional secondary defects, the Sunnybrook system can be an alternative to the other predominating grading systems.
authors.affiliation: Department of Surgical Sciences, Otorhinolaryngology and Head and Neck Surgery, University Hospital, Uppsala, Sweden. thomas.moe.berg@akademiska.se
authors.forename: Thomas
authors.initials: T
authors.lastname: Berg
authors.forename: Lars
authors.initials: L
authors.lastname: Jonsson
authors.forename: Mats
authors.initials: M
authors.lastname: Engström
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020330:Bell Palsy / Q000145:classification* / Q000503:physiopathology*; D004568:Electrodiagnosis / Q000379:methods*; D005154:Facial Nerve / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009410:Nerve Degeneration / Q000145:classification* / Q000503:physiopathology; D009431:Neural Conduction / Q000502:physiology; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis