Radiation Oncology/Toxicity/Facial nerve

Facial Nerve Toxicity

Grading

House-Brackmann Scale

Grade	Definition
I	Normal symmetrical function in all areas
II	Slight weakness noticeable only on close inspection Complete eye closure with minimal effort Slight asymmetry of smile with maximal effort Synkinesis barely noticeable, contracture, or spasm absent
III	Obvious weakness, but not disfiguring May not be able to lift eyebrow Complete eye closure and strong but asymmetrical mouth movement with maximal effort Obvious, but not disfiguring synkinesis, mass movement or spasm
IV	Obvious disfiguring weakness Inability to lift brow Incomplete eye closure and asymmetry of mouth with maximal effort Severe synkinesis, mass movement, spasm
V	Motion barely perceptible Incomplete eye closure, slight movement corner mouth Synkinesis, contracture, and spasm usually absent
VI	No movement, loss of tone, no synkinesis, contracture, or spasm