ENT Evaluation of acute facial paralysis House-Brackman grade system I, moderate dysfunction I obvious but not disfiguring difference between two side a No function impairment Noticeable but not severe synkinesis, contracture, and hemifacial spasm At rest: normal symmetry and tone Motion I slight to no movement of forehead J Ability to close eye with maximal effort and obvious asymmetry Ability to move corners of mouth with maximal effort and obvious asymmetry Patients with obvious but not disfiguring synkinesis, contracture, and d hemifacial spasm are grade 3 regardless of degree of motor activityEvaluation of acute facial paralysis ◼ House-Brackman grade system ◼ III, moderate dysfunction: ◼ obvious but not disfiguring difference between two side ◼ No function impairment ◼ Noticeable but not severe synkinesis, contracture, and hemifacial spasm ◼ At rest: normal symmetry and tone ◼ Motion: ◼ slight to no movement of forehead ◼ Ability to close eye with maximal effort and obvious asymmetry ◼ Ability to move corners of mouth with maximal effort and obvious asymemetry ◼ Patients with obvious but not disfiguring synkinesis, contracture, and hemifcial spasm are grade 3 regardless of degree of motor activity