Abstract
OBJECTIVE
To study the correlation between Sunnybrook and House-Brackmann facial grading systems at different time-points of peripheral facial palsy.
METHOD
Prospective study conducted 2001 to 2007 in 17 tertiary otorhinolaryngological centers. The facial function of 1,920 peripheral facial palsy patients aged 18 to 72 was assessed 5,397 times with both Sunnybrook and House-Brackmann facial grading systems. Grading was done within 72 hours of palsy onset (initial visit), at days 11 to 17, and at 1 month, 2 months, 3 months, 6 months, and 12 months. Box plot analysis was used to show how Sunnybrook composite scores correlated with House-Brackmann grades. Spearman correlation coefficient was also calculated.
RESULTS
Spearman correlation coefficient varied from −0.81 to −0.96, with the weakest correlation found at initial visit. Box plot analysis for all assessments revealed a wide overlapping of Sunnybrook scores and House-Brackmann grades. With 50 percent of the results closest to the median (the lower quartile-upper quartile range), Sunnybrook composite scores varied in House-Brackmann grades as follows: Grade I, 100; Grade II, 71 to 90; Grade III, 43 to 62; Grade IV, 26 to 43; Grade V, 13 to 25; and Grade VI, 5 to 14.
CONCLUSION
Gradings correlated better in follow-up assessments than at the initial visit assessment. As shown by the wide overlap of the grading results, subjective grading systems are only approximate. However, a conversion table for Sunnybrook and House-Brackmann was obtained, which can be used in further development of facial grading systems.