House-Brackmann面神经分级标准

House-BrackmannscoreTheHouse-Brackmannscoreisascoretogradethedegreeofnervedamageinafacialnervepalsy.Themeasurementisdeterminedbymeasuringtheupwards(superior)movementofthemid-portionofthetopoftheeyebrow,andtheoutwards(lateral)movementoftheangleofthemouth.Eachreferencepointscores1pointforeach0.25cmmovement,uptoamaximumof1cm.Thescoresarethenaddedtogether,togiveanumberoutof8.[1]GradeDescriptionMeasurementFunction%EstimatedFunction%INormal8/8100100IISlight7/876-9980IIIModerate5/8-6/851-7560IVModeratelySevere3/8-4/826-5040VSevere1/8-2/81-2520VITotal0/800[edit]References^HouseJW,BrackmannDE(1985).Facialnervegradingsystem.OtolaryngolHeadNeckSurg93:146–147.PMID3921901.House-BrackmanScale(facialnervepalsy)TheHouse-BrackmannscalerangesbetweenI(normal)andVI(nomovement).GradeINormalsymmetricalfunctionGradeIISlightweaknessnoticeableonlyoncloseinspectionCompleteeyeclosurewithminimaleffortSlightasymmetryofsmilewithmaximaleffortSynkinesisbarelynoticeable,contracture,orspasmabsentGradeIIIObviousweakness,butnotdisfiguringMaynotbeabletolifteyebrowCompleteeyeclosureandstrongbutasymmetricalmouthmovementObvious,butnotdisfiguringsynkinesis,massmovementorspasmGradeIVObviousdisfiguringweaknessInabilitytoliftbrowIncompleteeyeclosureandasymmetryofmouthwithmaximaleffortSeveresynkinesis,massmovement,spasmGradeVMotionbarelyperceptibleIncompleteeyeclosure,slightmovementcornermouthSynkinesis,contracture,andspasmusuallyabsentGradeVINomovement,lossoftone,nosynkinesis,contracture,orspasmReferenceHouseJW,BrackmannDE.Facialnervegradingsystem.Otolaryngol.HeadNeckSurg1985;93:146–147.House-BrackmanfacialparalysisscaleGradeImpairmentINormalIIMilddysfunction(slightweakness,normalsymmetryatrest)IIIModeratedysfunction(obviousbutnotdisfiguringweaknesswithsynkinesis,normalsymmetryatrest)Completeeyeclosurew/maximaleffort,goodforeheadmovementIVModeratelyseveredysfunction(obviousanddisfiguringasymmetry,significantsynkinesis)Incompleteeyeclosure,moderateforeheadmovementVSeveredysfunction(barelyperceptiblemotion)VITotalparalysis(nomovement)SpontaneousnystagmusFirstdegree:nystagmusongazetowardthequickcomponentSeconddegree:nystagmusongazetowardthequickcomponentandonstraightgazeThirddegree:nystagmusinalldirectionsofgazeHouse-Brackmann面神经分级标准分为6等级，Ⅰ级：正常，Ⅵ级：完全麻痹。每个等级有测量面神经运动部位的具体内容。测量抬眉及口角的运动幅度，并与健侧进行比较，再将这些结果转换成6等级.Ⅰ级：面部运动功能正常，没有无力及联带运动。Ⅱ级：面部运动功能仅有轻度不对称，可能有轻度的联带运动。Ⅲ级：有明显的不对称及明显的继发性缺陷（即并发症），但是额部有运动，额部运动的出现表示神经功能没有完全变性。Ⅳ级：明显不对称，没有额部运动，面部无力伴有毁容性联带运动或集团性运动。Ⅴ级：面部仅有轻微的运动，额部没有运动，面部功能没有恢复到出现继发性缺陷。Ⅵ级：患面部没有任何的运动或肌张力消失。