• Journal of Acupuncture Research
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• 제33권4호
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• pp.101-108
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• 2016

Objectives : Among the assessment tools for evaluating facial function, the House-Brackmann scale is used as a standard tool, but it has some shortcomings. The Sunnybrook Facial Grading System can assess the after effects of facial palsy and facial movement by each part of the face. By understanding the application state of this Sunnybrook Facial Grading System, we intend to analyze the relationship between House-Brackmann scale score and Sunnybrook Facial Grading System score so that we can examine the advantages of the Sunnybrook Facial Grading System as a more accurate tool. Methods : We screened both inpatients and outpatients who visited the Facial Palsy Center at Kyung Hee University Hospital for Korean medical treatment and were evaluated with the Sunnybrook Facial Grading System from December 2015 to October 2016. A total of 159 out of 166 patients were studied, including basic characteristics and missing data. We used descriptive statistics for general features of patients and SPSS Ver.18 for statistical analysis. Results : House-Brackmann scale and Sunnybrook Facial Grading System have high negative correlation through Pearson Correlation Coefficient with a score of -0.884. Analyzing outlier data resulting from relation analysis between the House-Brackmann scale and the Sunnybrook Facial Grading System showed many outliers when the damaged state of each part of the face is different. Conclusion : Sunnybrook Facial Grading System can make up for faults of the House-Brackmann scale, which is inferior in accuracy when each damage status of each part of the face is different. Sunnybrook Facial Grading System performs a detailed assessment of facial function and sequelae of facial palsy easier than the House-Brackmann scale.

• Archives of Plastic Surgery
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• 제48권3호
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• pp.269-277
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• 2021

Background The Sunnybrook facial grading scale is a comprehensive scale for the evaluation of facial paralysis patients. Its results greatly depend on subjective input. This study aimed to develop and validate an automated Sunnybrook facial grading scale (SBface) to more objectively assess disfigurement due to facial paralysis. Methods An application compatible with iOS version 11.0 and up was developed. The software automatically detected facial features in standardized photographs and generated scores following the Sunnybrook facial grading scale. Photographic data from 30 unilateral facial paralysis patients were randomly sampled for validation. Intrarater reliability was tested by conducting two identical tests at a 2-week interval. Interrater reliability was tested between the software and three facial nerve clinicians. Results A beta version of the SBface application was tested. Intrarater reliability showed excellent congruence between the two tests. Moderate to strong positive correlations were found between the software and an otolaryngologist, including the total scores of the three individual software domains and composite scores. However, 74.4% (29/39) of the subdomain items showed low to zero correlation with the human raters (κ<0.2). The correlations between the human raters showed good congruence for most of the total and composite scores, with 10.3% (4/39) of the subdomain items failing to correspond (κ<0.2). Conclusions The SBface application is efficient and accurate for evaluating the degree of facial paralysis based on the Sunnybrook facial grading scale. However, correlations of the software-derived results with those of human raters are limited by the software algorithm and the raters' inconsistency.

• 한방안이비인후피부과학회지
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• 제20권3호
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• pp.147-160
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• 2007

Background and Objective : The facial nerve grading system proposed by House and Brackmann is most widely accepted for the clinical assessment of facial nerve injury. Because of the limitations and subjectivity of the House-Brackmann scale, several new scales of varying degrees of objectivity and ease of use have been introduced. To assess methods of evaluating the function of the facial nerve that have been introduced over the past 20 years, We compared with the House-Brackmann scale. Method : We referred to the information through Entrez Pubmed and Korean studies information(KSI) from 1985 to 2006 about methods of evaluating facial nerve function. We choose 7 scales that focused on objective and easy of use. Result and conclusion : Sunnybrook scale is a weighted, subjective scale with incorporation of secondary defects into a single composite score. Sunnybrook scale can be recommended over House-Brackmann scale.

• Journal of Acupuncture Research
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• 제33권3호
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• pp.117-127
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• 2016

Objectives : This study was performed to observe the effect of complex therapy, including electro-acupuncture and magnetic-acupuncture, on peripheral facial nerve palsy. Methods : Nine patients with peripheral facial nerve palsy were treated with acupuncture using electrical and magnetic stimulation. Acupoints in the face were stimulated with an electromagnetic field, as widely and as evenly as possible. To evaluate the effects before and after treatment we used Yanagihara's unweighted grading system, House-Brackmann scale, and Sunnybrook facial grading system and image once a week. Results : After treatment, the scores of Yanagihara's unweighted grading system, House-Brackmann scale and Sunnybrook facial grading system each improved (p-value < 0.05). Conclusion : Complex therapy using electro-acupuncture and magnetic-acupuncture might be an effective treatment to improve symptoms of peripheral facial nerve palsy. Further randomized-controlled trials are required to verify the efficacy and results of this study.

• Journal of Acupuncture Research
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• 제33권3호
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• pp.89-99
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• 2016

Objectives : This study was performed to develop objective methods for evaluating facial palsy sequelae using a 3D Facial Scanning System. Methods : Fifty-eight patients with facial palsy sequelae were selected. Their medical records were reviewed to collect demographic data, facial palsy sequelae evaluation, Facial Disability Index questionnaire, and test results (3D Facial Scanning System). Five different facial expressions (at rest, eye closure, eyebrow elevation, smiling, and whistling) were photographed. Sunnybrook Scale was associated with distances between predetermined facial points. Results : The average Sunnybrook composite score was $58.88{\pm}17.31$. Secondary movements (mouth to eye synkinesis, contracture of eye, and contracture of mouth) showed significant difference according to the Sunnybrook Scale. In voluntary movements, eyebrow height at eyebrow elevation, length between mouth angle and central line while whistling, and eyelid width at maximum eye opening showed significant difference. Facial palsy Sequelae Index (FSI) was correlated with Sunnybrook sub-scales (resting symmetry, voluntary movement, and synkinesis). Conclusion : These results demonstrate that a 3D Facial Scanning System is useful for evaluating facial palsy sequelae. This method may facilitate objective evaluation for facial palsy sequelae and it could be applied in clinical trials.

• 한방안이비인후피부과학회지
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• 제32권1호
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• pp.59-73
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• 2019

Objectives : The purpose of this study is to confirm and to suggest the Korean medical treatment is effective treatments to patients with facial paralysis sequelae. Methods : We conducted a survey on patients with facial paralysis sequelae who visited the facial paralysis center from August 2017 to November 2018. We then evaluated House-Brackmann Grading System(HBGS), Sunnybrook Scale(S-Scale), Visual analog scale(VAS) against those who agreed and analyzed the information through Electronic Medical Record(EMR) and Order Communication System(OCS). Results : Clinically, Korean medical treatment such as embedding therapy are effective for the facial paralysis sequelae. For the purpose of raising the level of evidence against this, research will be needed to confirm the treatment effects by comparing accurate assessment indicators that are conducted before and after the treatment. Conclusions : In order to confirm the progress of treatment of facial paralysis sequelae, evaluation indicators such as House-Brackmann Grading System and Sunnybrook Scale should be performed by experts. And after 3-4 weeks, if patients have any sequelae symptoms, it may be helpful to take treatments such as pharmacopuncture treatment and embedding therapy at intervals of 1-2 weeks depending on the symptoms or areas.

• Journal of Acupuncture Research
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• 제30권5호
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• pp.107-116
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• 2013

Objjectives : The purpose of this study is to investigate the correlation between surface electromyography(SEMG) and assessment scales for facial palsy. Methods : The subjects for this study were 21 patients who had peripheral facial nerve palsy. We analyzed about the correlation between the results of SEMG and facial nerve assessment scales that were carried out at the same time. The assessment scales used in this study were House-Brackmann scale, Yanagihara grading system, Sunnybrook facial grading system. Results : There are considerable correlation between the results of SEMG and the results of three kinds of assessment scales for facial nerve palsy. Conclusions : SEMG may be an objective examination for facial nerve palsy. Some research aimed at development of SEMG examination guideline for facial nerve palsy will be needed after this. And we expect that many researches for development of diagnostic equipments or treatment equipments that utilize SEMG will proceed.

• 한방재활의학과학회지
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• 제33권2호
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• pp.87-94
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• 2023

This study aims to demonstrate the effectiveness of facial chuna manual therapy in treating the sequelae of Bell's palsy. Four patients were treated with facial chuna manual therapy once a week for 4 weeks, consisting of facial muscle massage, acupoint pressure, contracture chuna, and synkinesis chuna. The changes in symptoms (contracture and sysnkinesis) were measured using the Sunnybrook Facial Grading Scale (SFGS), Synkinesis Assessment Questionnaire (SAQ), Facial Disability Index (FDI), Contracture/Synkinesis scale using a facial scanning system, Numeric Rating scale (NRS) for synkinesis or contracture, and Was It Worth It questionnaire. After treatments, SFGS, Contracture/Synkinesis scale, and NRS for synkinesis or contracture showed significant improvements. SFGS increased in three cases from 39~76 to 52~85 score. SAQ decreased in two cases from 53.33~57.78 to 40.00~55.56. FDI increased in three cases from 120~128 to 138~145. These results suggest that Korean medicine treatment, including facial chuna manual therapy can be effective in improving the sequelae of Bell's palsy.

• 혜화의학회지
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• 제25권1호
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• pp.53-62
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• 2016

Objectives : The purpose of this study was to report a case of a patient efficacy of electromagnetic acupuncture using Whata 153 in facial nerve palsy in Herpes zoster oticus. Methods : We treated the patient with magnetic acupuncture combined with electro-acupuncture. Acupuncture points were at the face (BL2, GB14, TE23, ST4, ST6, ST3). All the acupuncture points were stimulated with magnetic field and 4 of them were combined with electro-acupuncture. Results & Conclusions : The improvement of facial movement and symptom was evaluated by Yanagihara grading system(Y-system), House-Brackmann scale(HB scale) and Sunnybrook facial grading system(SFGS). After treatment, all of the scales(Y-system, HB scale and SFGS) and symptom of the patient were improved. From the above results, we suggest that magnetic acupuncture and electro-acupuncture might be effective on facial nerve palsy in Herpes zoster oticus.

• 대한약침학회지
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• 제21권4호
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• pp.258-267
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• 2018

Objectives: The purpose of this study was to find out validity of Surface Electromyography(sEMG) compared with Nerve Conduction Study and clinical assessment scale as assessment factors for facial palsy. Methods: We investigated 50 cases of patients with peripheral facial palsy who had records of sEMG and NCS to check. Then we analyzed the correlation between sEMG and NCS that carried out around 1 week after onset. And we analyzed the correlation between sEMG and clinical assessment scales that were measured three times around 1 week, 3-4 weeks and 5-6 weeks after onset. Clinical assessment scales used in this study were House-brackmann grade, Yanagihara unweighted grading scale and Sunnybrook facial grading system. We used Pearson's correlation for statistical analysis. Results: sEMG and NCS, measured at similar times, were statistically correlated. Especially, the correlation with the forehead region was high. And sEMG and clinical assessment scale, measured at same time, were statistically correlated, especially after 5 weeks from onset. Conclusion: According to this study, sEMG is expected to be useful to assessment facial palsy.