title: Reliability of postoperative photographs in assessment of facial nerve function after vestibular schwannoma resection.
abstract: OBJECTIVE
  This study was undertaken to assess the reliability of observations of postoperative photographs in assigning House-Brackmann scores as outcome measures for patients following resection of vestibular schwannomas.
  
  
  METHODS
  Forty pictures of differing facial expressions typically elicited from patients for assigning House-Brackmann scores were individually evaluated by neurosurgery residents and faculty members at the University of Alabama at Birmingham; a score was assigned to each picture by the individual raters. The interrater reliability was measured using the Spearman correlation coefficient, Kendall coefficient of concordance, and kappa statistic; internal consistency was calculated using the Cronbach alpha reliability estimate.
  
  
  RESULTS
  The Spearman correlation coefficients showed strong positive association among raters, with a range of values of 0.66 to 0.90. Internal consistency measured by the Cronbach alpha coefficient was excellent (α = 0.97). The Kendall coefficient of concordance for the ordinal grades suggested a substantial degree of agreement among the raters (w = 0.76, p < 0.001).
  
  
  CONCLUSIONS
  Static postoperative photographs are a reliable outcome measure for determining facial nerve function after vestibular schwannoma resection and may serve as a surrogate for the dynamic patient interview.
authors.affiliation: Division of Neurosurgery, Department of Surgery, University of Alabama at Birmingham, Alabama, USA. agordon@uabmc.edu
authors.forename: Amber S
authors.initials: AS
authors.lastname: Gordon
authors.forename: Ashly C
authors.initials: AC
authors.lastname: Westrick
authors.forename: Michael I
authors.initials: MI
authors.lastname: Falola
authors.forename: Chevis N
authors.initials: CN
authors.lastname: Shannon
authors.forename: Beverly C
authors.initials: BC
authors.lastname: Walters
authors.forename: Winfield S
authors.initials: WS
authors.lastname: Fisher
mesh_terms: D003627:Data Interpretation, Statistical; D005149:Facial Expression; D020220:Facial Nerve Injuries / Q000175:diagnosis* / Q000503:physiopathology; D005158:Facial Paralysis / Q000503:physiopathology; D006801:Humans; D009464:Neuroma, Acoustic / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D015588:Observer Variation; D010781:Photography; D011183:Postoperative Complications / Q000175:diagnosis*; D015203:Reproducibility of Results; D016896:Treatment Outcome