Monini Simonetta, Marinozzi Franco, Atturo Francesca, Bini Fabiano, Marchelletta Silvia, Barbara Maurizio
*Department of Neuroscience, Mental Health and Sensory Organs, Medicine and Psychology †Department of Mechanical and Aerospace Engineering, University La Sapienza, Rome, Italy.
Otol Neurotol. 2017 Sep;38(8):1178-1185. doi: 10.1097/MAO.0000000000001498.
To propose a new objective video-recording procedure to assess and monitor over time the severity of facial nerve palsy.
No objective methods for facial palsy (FP) assessment are universally accepted.
The face of subjects presenting with different degrees of facial nerve deficit, as measured by the House-Brackmann (HB) grading system, was videotaped after positioning, at specific points, 10 gray circular markers made of a retroreflective material. Video-recording included the resting position and six ordered facial movements. Editing and data elaboration was performed using a software instructed to assess marker distances. From the differences of the marker distances between the two sides was then extracted a score.
The higher the FP degree, the higher the score registered during each movement. The statistical significance differed during the various movements between the different FP degrees, being uniform when closing the eyes gently; whereas when wrinkling the nose, there was no difference between the HB grade III and IV groups and, when smiling, no difference was evidenced between the HB grade IV and V groups.The global range index, which represents the overall degree of FP, was between 6.2 and 7.9 in the normal subjects (HB grade I); between 10.6 and 18.91 in HB grade II; between 22.19 and 33.06 in HB grade III; between 38.61 and 49.75 in HB grade IV; and between 50.97 and 66.88 in HB grade V.
The proposed objective methodology could provide numerical data that correspond to the different degrees of FP, as assessed by the subjective HB grading system. These data can in addition be used singularly to score selected areas of the paralyzed face when recovery occurs with a different timing in the different face regions.
提出一种新的客观视频记录程序，以随时间评估和监测面神经麻痹的严重程度。
目前尚无被普遍接受的面神经麻痹（FP）客观评估方法。
对于根据House-Brackmann（HB）分级系统测量出具有不同程度面神经功能缺损的受试者，在特定位置贴上10个由反光材料制成的灰色圆形标记后，对其面部进行录像。视频记录包括静止位置和六种有序的面部动作。使用一个被设定为评估标记距离的软件进行编辑和数据处理。然后从两侧标记距离的差异中提取一个分数。
FP程度越高，每次动作时记录的分数越高。不同FP程度在各种动作中的统计学显著性有所不同，在轻轻闭眼时具有一致性；而在皱鼻时，HB III级和IV级组之间没有差异，在微笑时，HB IV级和V级组之间没有差异。代表FP总体程度的全局范围指数，在正常受试者（HB I级）中为6.2至7.9；在HB II级中为10.6至18.91；在HB III级中为22.19至33.06；在HB IV级中为38.61至49.75；在HB V级中为50.97至66.88。
所提出的客观方法可以提供与主观HB分级系统评估的不同FP程度相对应的数值数据。当不同面部区域恢复时间不同时，这些数据还可单独用于对瘫痪面部的选定区域进行评分。
