The Correlation between Facial Nerve Grading System 2.0 and the Sunnybrook Facial Grading System in Subjects with Facial Palsy: A Cross-Sectional Study

Document Type : Original Articles

Authors

1 Assistant Professor, Musculoskeletal Research Center, Rehabilitation Research Institute AND Department of Physical Therapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

2 Musculoskeletal Research Center, Rehabilitation Research Institute AND Department of Physical Therapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

3 MSc Student, Student Research Committee AND Musculoskeletal Research Center, Rehabilitation Research Institute AND Department of Physical Therapy, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

10.22122/jrrs.v14i2.3206

Abstract

Introduction: Over many years, several methods have been developed to evaluate the facial nerve palsy. Among them, Sunnybrook Facial Grading System (SFGS) and modified House-Brickmanne, known as Facial Nerve Grading System 2.0 (FNGS 2.0), grading systems have been the most favored methods to evaluate facial nerve health between therapists and researchers. The aim of this study was to compare these two evaluation approaches.Materials and Methods: In the present cross-sectional study, the videotapes for nineteen subjects diagnosed with facial nerve palsy were recorded before and after treatment. Then, the videotapes were evaluated using the SFGS and FNGS 2.0 scales by three specialists separately. The inter-rater agreement was reported using Intraclass correlation coefficient (ICC) scores. The correlation between the two evaluation approaches was determined using Spearman’s coefficient of correlation.Results: The ICC score for scoring by the specialists was 0.969 for SFGS and 0.904 for FNG 2.0. The FNG 2.0 and SFGS inter-system agreement reported as 0.848 (P < 0.01). The coefficient was higher before treatment (0.961), and decreased after treatment (0.777).Conclusion: Although the correlation between two systems was acceptable, the SFGS system was more sensitive than FNG 2.0.

Keywords

  1. Pereira LM, Obara K, Dias JM, Menacho MO, Lavado EL, Cardoso JR. Facial exercise therapy for facial palsy: Systematic review and meta-analysis. Clin Rehabil 2011; 25(7): 649-58.
  2. Ma MS, van der Hoeven JH, Nicolai JP, Meek MF. Sound-induced facial synkinesis following facial nerve paralysis. J Plast Reconstr Aesthet Surg 2009; 62(8): 1025-9.
  3. Clarke A. Psychosocial aspects of facial disfigurement: Problems, management and the role of a lay-led organization. Psychol Health Med 1999; 4(2): 127-42.
  4. House JW. Facial nerve grading systems. Laryngoscope 1983; 93(8): 1056-69.
  5. Brackmann DE, Barrs DM. Assessing recovery of facial function following acoustic neuroma surgery. Otolaryngol Head Neck Surg 1984; 92(1): 88-93.
  6. Croxson G, May M, Mester SJ. Grading facial nerve function: House-Brackmann versus Burres-Fisch methods. Am J Otol 1990; 11(4): 240-6.
  7. Murty GE, Diver JP, Kelly PJ, O'Donoghue GM, Bradley PJ. The Nottingham System: objective assessment of facial nerve function in the clinic. Otolaryngol Head Neck Surg 1994; 110(2): 156-61.
  8. Ross BG, Fradet G, Nedzelski JM. Development of a sensitive clinical facial grading system. Otolaryngol Head Neck Surg 1996; 114(3): 380-6.
  9. Rickenmann J, Jaquenod C, Cerenko D, Fisch U. Comparative value of facial nerve grading systems. Otolaryngol Head Neck Surg 1997; 117(4): 322-5.
  10. Pourmomeny AA, Asadi S, Cheatsaz A. Management of facial synkinesis with a combination of BTX-A and biofeedback: A randomized trial. Iran J Otorhinolaryngol 2015; 27(83): 409-15.
  11. Hu WL, Ross B, Nedzelski J. Reliability of the Sunnybrook Facial Grading System by novice users. J Otolaryngol 2001; 30(4): 208-11.
  12. Vrabec JT, Backous DD, Djalilian HR, Gidley PW, Leonetti JP, Marzo SJ, et al. Facial Nerve Grading System 2.0. Otolaryngol Head Neck Surg 2009; 140(4): 445-50.
  13. Kang TS, Vrabec JT, Giddings N, Terris DJ. Facial nerve grading systems (1985-2002): beyond the House-Brackmann scale. Otol Neurotol 2002; 23(5): 767-71.
  14. Fattah AY, Gurusinghe AD, Gavilan J, Hadlock TA, Marcus JR, Marres H, et al. Facial nerve grading instruments: Systematic review of the literature and suggestion for uniformity. Plast Reconstr Surg 2015; 135(2): 569-79.
  15. Soon SR, Heah H, Yuen HW. Facial Nerve Grading 2.0 and Sunnybrook Facial Grading System. Otolaryngol Head Neck Surg 2011; 145(2_suppl): 211-2.
  16. Hu WL, Ross B, Nedzelski J. Reliability of the Sunnybrook Facial Grading System by novice users. J Otolaryngol 2001; 30(4): 208-11.
  17. Henstrom DK, Skilbeck CJ, Weinberg J, Knox C, Cheney ML, Hadlock TA. Good correlation between original and modified House Brackmann facial grading systems. Laryngoscope 2011; 121(1): 47-50.
  18. Bolboaca SD, Jantschi L. Pearson versus Spearman, Kendall's tau correlation analysis on structure-activity relationships of biologic active compounds. Leonardo Journal of Sciences 2006; (9): 179-200.
  19. Fleiss JL. Design and Analysis of Clinical Experiments. Hoboken, NJ: Wiley; 2011.
  20. Berg T, Jonsson L, Engstrom M. Agreement between the Sunnybrook, House-Brackmann, and Yanagihara facial nerve grading systems in Bell's palsy. Otol Neurotol 2004; 25(6): 1020-6.
  • Receive Date: 22 December 2018
  • Revise Date: 25 April 2024
  • Accept Date: 22 May 2022