In House-Brackmann grading of facial nerve function, Grade III (moderate dysfunction) is characterised by which combination?

• A Normal face at rest; eye closure with minimal effort; slight asymmetry on movement
• B Obvious weakness; incomplete eye closure; no forehead movement; asymmetric mouth with maximum effort
• C Complete paralysis with no movement; exposure keratopathy present
• D Obvious weakness at rest; complete eye closure requiring effort; moderate forehead movement; slight mouth asymmetry ✓

Explanation

House-Brackmann Grade III (Moderate dysfunction): At rest — normal symmetry and tone. Motion — forehead: slight to moderate movement; eye: complete closure with effort; mouth: slightly weak with maximum effort. Synkinesis, contracture, and/or hemifacial spasm may be present. Grade II shows eye closure with minimal effort. Grade IV (moderately severe) shows no forehead movement and incomplete eye closure. Grade VI is complete paralysis. The H-B scale is the international standard for documenting facial nerve outcomes in Bell's palsy and acoustic neuroma surgery.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

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