Fazıl Necdet ARDIÇ, Erdem MENGİ, Taylan ÇİL, Hande ŞENOL, Fevzi BARLAY, Funda TÜMKAYA, Cüneyt Orhan KARA

Validation of the Turkish version of the Sunnybrook facial grading system

Background/aim: To adapt the Sunnybrook facial grading system (SFGS) into Turkish and perform validation and reliability studieson the Turkish version.Materials and Methods: The original English version of the SFGS was translated into Turkish by performing a linguistic validity studybased on international standards. The evaluators comprised 6 physicians. Evaluations were performed twice independently using thevideo recordings of 65 facial palsy patients. Synchronously, the House-Brackman facial grading system (HBFGS) was filled out to displayconcurrent validity. The intraclass correlation coefficient (ICC) and Cronbach’s alpha was used for the examination of the inter- andintra-rater reliability. As another indication of reliability, the generalizability (G) was also examined.Results: The ICC for the inter-rater reliability for resting symmetry, symmetry of voluntary movement, synkinesis, and the compositescore, which are 4 components of the SFGS, were determined, respectively, as 0.822, 0.956, 0.606, and 0.957 for the first evaluation, and0.805, 0.965, 0.584, and 0.965 for the second evaluation. For the intra-rater reliability, the ICC were determined as 0.842, 0.956, 0.794,and 0.937, while the Cronbach’s alpha coefficients were determined as 0.809, 0.956, 0.792, and 0.948, respectively. The G coefficient wasdetermined as G = 0.772. For the concurrent validity, a strong correlation was found between the SFGS and HBFGS scores.Conclusion: The present study adapted the SFGS into Turkish, and demonstrated that the adapted scale was valid and reliable. TheTurkish version can be used for the evaluation of facial palsy, the follow-up of treatment efficiency, and standardization in reportingoutcomes with the international literature.

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1. House JW, Brackmann DE. Facial nerve grading system. Otolaryngology-Head and Neck Surgery 1985; 93 (2): 146-147. doi: 10.1177/019459988509300202
2. Croxson G, May M, Mester SJ. Grading facial nerve function: House-Brackmann versus Burres-Fisch methods. The American Journal of Otology 1990; 11 (4): 240-246.
3. Rickenmann J, Jaquenod C, Cerenko D, Fisch U. Comparative value of facial nerve grading systems. Otolaryngology-Head and Neck Surgery 1997; 117 (4): 322-325. doi: 10.1016/S0194- 5998(97)70120-7
4. Ross BG, Fradet G, Nedzelski JM. Development of a sensitive clinical facial grading system. Otolaryngology-Head and Neck Surgery 1996; 114 (3): 380-386. doi: 10.1016/S0194- 59989670206-1
5. Fattah AY, Gurusinghe AD, Gavilan J, Hadlock TA, Marcus JR et al. Facial nerve grading instruments: systematic review of the literature and suggestion for uniformity. Plastic and Reconstructive Surgery 2015; 135 (2): 569-579. doi: 10.1097/ PRS.0000000000000905
6. Şeker H, Gençdoğan B. Psikoloijide ve eğitimde ölçme aracı geliştirme. 2.basım Ankara: Nobel Kitabevi; 2014 (In Turkish).
7. de Ru JA, Braunius WW, van Benthem PP, Busschers WB, Hordijk GJ. Grading facial nerve function: why a new grading system, the MoReSS, should be proposed. Otology and Neurotology 2006; 27 (7): 1030-1036. doi: 10.1097/01. mao.0000227896.34915.4f
8. Kahn JB, Gliklich RE, Boyev KP, Stewart MG, Metson RB et al. Validation of a patient-graded instrument for facial nerve paralysis: The FaCE scale. The Laryngoscope 2001; 111 (3): 387-398. doi: 10.1097/00005537-200103000-00005
9. Kang TS, Vrabec JT, Giddings N, Terris DJ. Facial nerve grading systems (1985-2002): Beyond the House-Brackmann scale. Otology and Neurotology 2002; 23 (5): 767-771. doi: 10.1097/00129492-200209000-00026
10. Coulson SE, Croxson GR, Adams RD, O’Dwyer NJ. Reliability of the “Sydney,” “Sunnybrook,” and “House Brackmann” facial grading systems to assess voluntary movement and synkinesis after facial nerve paralysis. Otolaryngology-Head and Neck Surgery 2005; 132 (4): 543-549. doi: 10.1016/j. otohns.2005.01.027
11. Yanagihara N. Grading of facial palsy. In: Fisch U (editor). Proceedings of the 3rd International Symposium on Facial Nerve Surgery. Zurich, Switzerland: Kugler Medical Publications, 1976. pp. 533-555.
12. Hu WL, Ross B, Nedzelski J. Reliability of the Sunnybrook Facial Grading System by novice users. The Journal of Otolaryngology 2001; 30 (4): 208-211. doi: 10.2310/7070.2001.20148
13. Kanerva M, Poussa T, Pitkäranta A. Sunnybrook and House- Brackmann facial grading systems: Intrarater repeatability and interrater agreement. Otolaryngology-Head and Neck Surgery 2006; 135 (6): 865-871. doi: 10.1016/j. otohns.2006.05.748
14. Neely JG, Cherian NG, Dickerson CB, Nedzelski JM. Sunnybrook facial grading system: reliability and criteria for grading. The Laryngoscope 2010; 120 (5): 1038-1045. doi: 10.1002/lary.20868
15. Pavese C, Tinelli C, Furini F, Abbamonte M, Giromini E et al. Validation of the Italian version of the Sunnybrook facial grading system. Neurological Sciences 2013; 34 (4): 457-463. doi: 10.1007/s10072-012-1025-x
16. Neumann T, Lorenz A, Volk GF, Hamzei F, Schulz S et al. Validation of the German Version of the Sunnybrook facial grading system. Laryngo-Rhino-Otologie 2017; 96 (3): 168- 174. doi:10.1055/s-0042-111512
17. Kayhan FT, Zurakowski D, Rauch SD. Toronto facial grading system: Interobserver reliability. Otolaryngology-Head and Neck Surgery 2000; 122 (2): 212-215. doi: 10.1016/S0194- 5998(00)70241-5
18. Vrabec JT, Backous DD, Djalilian HR, Gidley PW, Leonetti JP et al. Facial nerve grading system 2.0. Otolaryngology- Head and Neck Surgery 2009; 140 (4): 445-450. doi: 10.1016/j. otohns.2008.12.031