ENT Evaluation of acute facial paralysis House-Brackman grade system a V, severe dysfunction Only barely perceptible motion At rest: possible asymmetry with droop of corner of mouth and decreased or absent nasolabial fold Motion: No movement of forehead Incomplete closure of eye Slight movement of corner of mouth Synkinesis, contracture, and hemifacial spasm usually absent V, total paralysis: no movementEvaluation of acute facial paralysis ◼ House-Brackman grade system ◼ V, severe dysfunction: ◼ Only barely perceptible motion ◼ At rest: possible asymmetry with droop of corner of mouth and decreased or absent nasolabial fold ◼ Motion: ◼ No movement of forehead ◼ Incomplete closure of eye ◼ Slight movement of corner of mouth ◼ Synkinesis, contracture, and hemifacial spasm usually absent ◼ VI, total paralysis: no movement