Objective method for facial motricity grading in healthy individuals and in patients with unilateral peripheral facial palsy

Abstract 

Purposes

This study aimed (a) to associate the House and Brackmann grading system with a method of photographic evaluation and distance measuring between predetermined facial points, (b) to evaluate the objectivity of the method presented, and (c) to establish the grading pattern values for this method and their corresponding degrees in the House and Brackmann grading system.

Methods

This study presents a method for determining distances on each side of the face (eyebrow position and horizontal and vertical positions of mouth angle) related to 2 reference lines drawn from the internal ocular angles in photographs of 5 different facial expressions (at rest, eyes closed, eyebrows raised, smiling, and whistling) of 49 individuals with facial function from normal to total unilateral peripheral facial palsy.

Results

With this, an overall percentage of facial asymmetry was established.

Conclusions

1) It was possible to establish a correlation between the House and Brackmann grading system and a photographic evaluation method with measuring and comparative analysis of distances between predetermined facial points. 2) The method presented is objective. 3) Six percentages were established, which correlate to the 6 degrees of the House and Brackmann grading system. 4) The presented objective method is useful for documentation and following up of patients with peripheral facial palsy, particularly in university or medical training research studies.