Semin Plast Surg 2004; 18(1): 13-21
DOI: 10.1055/s-2004-823119
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001 USA.

Approaches to Grading Facial Nerve Function

Michael J. Brenner1 , J. Gail Neely1
  • 1Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, MO
Further Information

Publication History

Publication Date:
20 April 2004 (online)

Systematic evaluation of facial nerve paralysis allows the clinician to determine objectively the severity of disability, record and communicate this information to colleagues, and evaluate response to therapy. An ideal grading system would be precisely calibrated-at once accurate, reliable, and conducive to use in both the clinic and the research laboratory. Developing such a system has proved difficult, however. The complexity of facial nerve anatomy allows tremendous variation in clinical presentation, and assessments of facial expression are inherently subjective in nature. Carefully defined parameters are therefore crucial in performing objective and quantitative analyses. This article reviews the clinical considerations involved in grading facial function and traces the evolution of current approaches. Emphasis is placed upon advances in computer-based facial nerve grading.


J. Gail Neely, M.D. 

Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine

660 South Euclid Avenue, Box 8115

St. Louis, MO 63110