A comparison of facial grading systems.

There have been several attempts at establishing a grading system to estimate the severity of a facial palsy. This study compares the validity and consistency of all the leading systems. The results indicate that the systems are comparable and overall none had the advantage over the others. Interobserver variation had a significant effect on the consistency of the systems used, but experience of the observer was not a significant factor. The simplest classification studied was the House-Brackman system which is recommended.