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J Audiol Otol. 2019 Jan;23(1):53-58. English. Original Article.
Lee DY , Kim HS , Kim SY , Park KS , Kim YH .
Department of Otorhinolaryngology Head and Neck Surgery, Seoul National University Boramae Medical Center, Seoul, Korea.
Interdisciplinary Program of Bioengineering, Seoul National University, Seoul, Korea.
Department of Otorhinolaryngology Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
Department of Biomedical Engineering, College of Medicine, Seoul National University, Seoul, Korea.

Background and Objectives

The aim of the present study was to assess the feasibility of a PC-based facial asymmetry assessment program (PC-FAAP) and to compare the results of PC-FAAP with subjective regional scoring by raters in acute unilateral peripheral facial nerve paralysis (FNP).

Subjects and Methods

Participants were divided into 3 groups with 8 participants per group: group I, normal; group II, mild to moderate FNP; and group III, severe FNP. Using the PC-FAAP, the mouth asymmetry ratio (MAR), eyebrow asymmetry ratio (EAR), and complete eye closure asymmetry ratio (CAR) were calculated by comparing the movement of tracking points on both sides. The FNP grading scale (FGS) integrated each score, and the scores were weighted with a ratio of 5:3:2 (MAR:CAR:EAR). Subjective regional scoring was measured on a 0-100 scale score by three otologists. PC-FAAP and subjective scoring were compared in each group regarding the consistency of the results.


The mean scores of the MAR, EAR, CAR, and FGS of each group were significantly different. PC-FAAP showed significant differences between the three groups in terms of MAR, EAC, CAR, and FGS. PC-FAAP showed more consistent results than subjective assessment (p < 0.001). The PC-FAAP was significantly more consistent in group I and group III (p < 0.001 and p=0.002, respectively). FGS in group III was the only parameter that showed a more consistent result in PC-FAAP than the subjective scoring (p=0.008).


An FNP grading system using a PC-based program may provide more consistent results, especially for severe forms.

Copyright © 2019. Korean Association of Medical Journal Editors.