Grading facial nerve function: Why a new grading system, the MoReSS, should be proposed

Objective: To compare the interobserver variability of a new grading system to the currently recommended House-Brackmann Grading Scale. Study Design: Prospective case-control study. Setting: Tertiary referral center. Patients: All patients with a facial nerve paresis/paralysis (whatever the cause). Intervention: All patients were evaluated for their facial nerve function by three observers, independently, using both the new system and the House-Brackmann Grading Scale. Main Outcome Measure: The level of agreement between the three observers using both scales. Results: With the movement, rest, secondary defects, and subjective scoring grading scale, a higher percentage of agreement between the observers was noticed than with the House-Brackmann Grading Scale. Conclusion: The movement, rest, secondary defects, and subjective scoring grading system is more useful for grading facial nerve dysfunction in clinical practice than the House-Brackmann Grading Scale.