House-Brackmann Facial Nerve Grading System

 

House-Brackmann Grade Description
  1. Normal
 Normal function in all parts of the facial nerve
2. Mild Dysfunction At Rest: Normal

Forehead: moderate to good function

Eyes: Complete closure with mild effort

Mouth: Mild asymmetry
3. Moderate Dysfunction At Rest: Normal

Forehead: moderate function

Eyes: Complete closure with effort

Mouth: weakness with maximal effort
4. Moderately Severe Dysfunction At Rest: Normal

Forehead: no movement

Eyes: Incomplete closure

Mouth: asymmetry with maximal effort
5. Severe Dysfunction At Rest: Asymmetry obvious

Forehead: no movement

Eyes: incomplete closure

Mouth: Minimal movement
6. Total Palsy No movement with any parts of the facial nerve

Reference:

House JW, Brackmann DE. Facial nerve grading system. Otolaryngol Head Neck Surg. 1985;93(2):146-7.