Facial Nerve Grading System 2.0.
OBJECTIVE
To present an updated version of the original Facial Nerve Grading Scale (FNGS), commonly referred to as the House-Brackmann scale.


METHODS
Controlled trial of grading systems using a series of 21 videos of individuals with varying degrees of facial paralysis.


RESULTS
The intraobserver and interobserver agreement was high among the original and revised scales. Nominal improvement is seen in percentage of exact agreement of grade and reduction of instances of examiners differing by more then one grade when using FNGS 2.0. FNGS 2.0 also offers improved agreement in differentiating between grades 3 and 4.


CONCLUSIONS
FNGS 2.0 incorporates regional scoring of facial movement, providing additional information while maintaining agreement comparable to the original scale. Ambiguities regarding use of the grading scale are addressed.
Vrabec
Jeffrey T
JT
Bobby R Alford Department of Otolaryngology, Head and Neck Surgery, Baylor College of Medicine, Houston, TX 77030, USA. jvrabec@bcm.tmc.edu
Backous
Douglas D
DD
Djalilian
Hamid R
HR
Gidley
Paul W
PW
Leonetti
John P
JP
Marzo
Sam J
SJ
Morrison
Daniel
D
Ng
Matthew
M
Ramsey
Mitchell J
MJ
Schaitkin
Barry M
BM
Smouha
Eric
E
Toh
Elizabeth H
EH
Wax
Mark K
MK
Williamson
Robert A
RA
Smith
E O'Brian
EO