THE NOTTINGHAM SYSTEM - OBJECTIVE ASSESSMENT OF FACIAL-NERVE FUNCTIONIN THE CLINIC

The House-Brackmann is the most widely accepted system for the clinica l assessment of facial nerve function. It is, however, being subjectiv e and discontinuous, prone to interobserver variation. The need for an objective system persists. The Nottingham System is described and com pared to the Burres-Fisch system in a study of 29 subjects with varyin g degrees of facial nerve function, ranging from normal to total paral ysis. Within-group component of variance analysis was 7% for the Notti ngham System compared to 26% for the Burres-Fisch system. Bland and Al tmans' analysis showed the Burres-Fisch system to be biased, overestim ating small percentage scores, and underestimating large ones. The Not tingham System proved unbiased. The Nottingham System is recommended a s an accurate objective continuous grading system for the rapid assess ment of facial nerve function in the clinic.