title: Facial Nerve Grading System 2.0.
abstract: 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.
authors.affiliation: Bobby R Alford Department of Otolaryngology, Head and Neck Surgery, Baylor College of Medicine, Houston, TX 77030, USA. jvrabec@bcm.tmc.edu
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Vrabec
authors.forename: Douglas D
authors.initials: DD
authors.lastname: Backous
authors.forename: Hamid R
authors.initials: HR
authors.lastname: Djalilian
authors.forename: Paul W
authors.initials: PW
authors.lastname: Gidley
authors.forename: John P
authors.initials: JP
authors.lastname: Leonetti
authors.forename: Sam J
authors.initials: SJ
authors.lastname: Marzo
authors.forename: Daniel
authors.initials: D
authors.lastname: Morrison
authors.forename: Matthew
authors.initials: M
authors.lastname: Ng
authors.forename: Mitchell J
authors.initials: MJ
authors.lastname: Ramsey
authors.forename: Barry M
authors.initials: BM
authors.lastname: Schaitkin
authors.forename: Eric
authors.initials: E
authors.lastname: Smouha
authors.forename: Elizabeth H
authors.initials: EH
authors.lastname: Toh
authors.forename: Mark K
authors.initials: MK
authors.lastname: Wax
authors.forename: Robert A
authors.initials: RA
authors.lastname: Williamson
authors.forename: E O'Brian
authors.initials: EO
authors.lastname: Smith