Lin Zhanxiang, Fei Xiaoyang, Huang Lichao, Shao Yuchun, Liu Zicai
Department of Rehabilitation Medicine, Shaoguan First People's Hospital, Shaoguan, Guangdong Province, China.
Department of Rehabilitation Medicine, Yuebei People's Hospital, Shaoguan, Guangdong Province, China.
PLoS One. 2025 Jun 25;20(6):e0326789. doi: 10.1371/journal.pone.0326789. eCollection 2025.
Studies have shown that approximately 30% of patients with Bell's palsy may experience permanent disfigurement due to muscle weakness affecting facial expressions. The prognosis for Bell's palsy is often correlated with the degree of impairment in facial nerve function observed in the early stages of the condition. Selecting appropriate assessment tools is essential for the effective treatment and prognosis of patients with Bell's palsy.
Examine and compare three scales used to measure Bell's palsy: the House-Brackmann Grading Scale (HBGS), the Sunnybrook Facial Grading System (SFGS), and the Modified Portmann Scale (MPS).
A retrospective study involved 97 patients with Bell's palsy treated at the authors' institution from 2021 to 2022. The authors accessed these data for research purposes in February 2025. The patient cohort underwent HBGS, SFGS, and MPS to assess facial nerve function before and after treatment. We compared the results of these three evaluation methods. Additionally, we performed correlation analyses and receiver operating characteristic (ROC) analyses of the post-treatment data to examine the relationships between HBGS and SFGS and between HBGS and MPS, using the internationally recognized and most widely utilized HBGS as the standard.
The HBGS demonstrated moderate consistency with both the FSGS and MPS, revealing significant negative correlations (r = -0.876, P < 0.01; r = -0.860, P < 0.01). All three scales exhibited high reactivity and showed no ceiling/floor effect. The optimal cut-off values for the FSGS and MPS were determined to be ≤ 68 and ≤ 16 points, respectively, with AUC of 0.948 (95% CI: 0.910-0.984) and 0.931 (95% CI: 0.883-0.968).
HBGS, SFGS, and MPS are all appropriate tools for assessing Bell's palsy. The severity of facial nerve palsy can be clinically classified using a transect score of 68 on the SFGS and 16 on the MPS. However, the results should be interpreted with caution, as objective indicators were not utilized as criteria.
研究表明，约30%的贝尔面瘫患者可能因影响面部表情的肌肉无力而出现永久性容貌损毁。贝尔面瘫的预后通常与疾病早期观察到的面神经功能受损程度相关。选择合适的评估工具对贝尔面瘫患者的有效治疗和预后至关重要。
检验并比较用于评估贝尔面瘫的三种量表：House-Brackmann分级量表（HBGS）、桑尼布鲁克面部分级系统（SFGS）和改良波特曼量表（MPS）。
一项回顾性研究纳入了2021年至2022年在作者所在机构接受治疗的97例贝尔面瘫患者。作者于2025年2月获取这些数据用于研究目的。该患者队列在治疗前后接受了HBGS、SFGS和MPS评估面神经功能。我们比较了这三种评估方法的结果。此外，我们对治疗后的数据进行了相关性分析和受试者工作特征（ROC）分析，以国际认可且使用最广泛的HBGS作为标准，检验HBGS与SFGS之间以及HBGS与MPS之间的关系。
HBGS与FSGS和MPS均显示出中度一致性，呈现出显著的负相关（r = -0.876，P < 0.01；r = -0.860，P < 0.01）。所有三种量表均表现出高反应性，且未显示出天花板/地板效应。FSGS和MPS的最佳截断值分别确定为≤68分和≤16分，曲线下面积（AUC）分别为0.948（95%置信区间：0.910 - 0.984）和0.931（95%置信区间：0.883 - 0.968）。
HBGS、SFGS和MPS都是评估贝尔面瘫的合适工具。面神经麻痹的严重程度可通过SFGS上的68分横断面评分和MPS上的16分进行临床分类。然而，由于未将客观指标用作标准，结果应谨慎解读。
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