Lewis B I, Adour K K
Department of Head and Neck Surgery, Kaiser Permanente Medical Center, Walnut Creek, CA 94596, USA.
Eur Arch Otorhinolaryngol. 1995;252(5):265-9. doi: 10.1007/BF00185387.
Lack of uniformity in reporting facial nerve recovery in patients with facial nerve paralysis has been a major disadvantage in comparing treatment modalities. To remove subjectivity from the analysis, we devised a facial paralysis recovery profile as a system for measuring facial motion. This profile has been used since 1968 at Kaiser Permanente Medical Center, Oakland, California. The House facial paralysis grading system was introduced in 1983 for clinical use and was modified by Brackmann in 1985. This latter system has since been accepted by the American Academy of Otolaryngology-Head and Neck Surgery in the United States as the standard used in reporting results. In a prospective study of 54 patients, we tested multiple parameters that affect accurate reporting. We tested reliability and accuracy of facial measurements by using 30 control subjects and 3 independent examiners. We used Pearson correlation coefficients to statistically analyze results. To compare our system with the House-Brackmann grading system, we measured facial motions of 24 patients randomly selected from our data bank. All had incomplete returns of facial function and facial defects associated with faulty regeneration of a partially denervated facial nerve. Our overall results show defects in the House-Brackmann system which should be addressed. We offer the Adour-Swanson grading system as a reliable, easy-to-use, suitable alternative to the House-Brackmann system.
在比较治疗方式时，面神经麻痹患者面神经恢复情况报告缺乏一致性一直是一个主要弊端。为了在分析中消除主观性，我们设计了一种面瘫恢复概况作为测量面部运动的系统。自1968年以来，该概况一直在加利福尼亚州奥克兰的凯撒永久医疗中心使用。1983年引入了豪斯面瘫分级系统用于临床，并于1985年由布拉克曼进行了修改。此后，后一种系统被美国耳鼻咽喉头颈外科学会接受为报告结果时使用的标准。在一项对54例患者的前瞻性研究中，我们测试了影响准确报告的多个参数。我们使用30名对照受试者和3名独立检查者测试了面部测量的可靠性和准确性。我们使用皮尔逊相关系数对结果进行统计分析。为了将我们的系统与豪斯-布拉克曼分级系统进行比较，我们测量了从我们的数据库中随机选择的24例患者的面部运动。所有患者面部功能恢复均不完全，且面部缺陷与部分失神经支配的面神经再生不良有关。我们的总体结果显示了豪斯-布拉克曼系统中存在的缺陷，应予以解决。我们提供阿杜尔-斯旺森分级系统，作为豪斯-布拉克曼系统可靠、易用且合适的替代方案。
