About this app

Clinicians who deal with patients with facial paresis of any type are familiar with the House-Brackman grading system, which estimates the degree of facial function, assigning patients to grades I thru VI. This tried-and-true method has been the standard for many years, and has the advantages of speed and ease of use. However, there are also some negatives (lack of precision, inability to describe improvement within a category, inconsistancies with significant synkinesis, and problematic application when adjunctive surgical procedures have been done). The Sunnybrook system is an elegant method of estimating the degree of facial function as an intuitive 0% through 100% and overcomes the above noted problems with the House-Brackman system. The major difficulties with the Sunnybrook system are that it is time-consuming, and it requires a significant amount of writing down numerical estimates and application of a number of mathematical calculations; therefore it is often impractical in a busy office setting. This application allows a busy clinician to easily input the data with simple clicks on a smart phone, eliminating writing, math, and even the need to deal with numbers, and produces the facial function percent in about 60 seconds. The result (patient name, date of visit, and facial function percent) may be stored in a database, which can be edited or exported to a text file. For those interested in more detailed information regarding the Sunnybrook system, one of the original published articles is in Otolaryngology/Head and Neck Surgery, 1996, vol. 114 p. 380. This app was developed by a neuro-otologist who uses it frequently in his busy private practice.