CranioCalc

Calculators

eFACE

Clinician-graded facial function scale with 16 visual analogue items and static, dynamic, and synkinesis subscores.

Grade the affected side against the normal side. 100 is balanced position, normal movement, or no synkinesis. For items that can be abnormal in either direction, the scale runs to 200, and the distance from 100 is what counts.

Static (at rest)

100
Low (ptotic)BalancedHigh
100
NarrowBalancedWide
100
EffacedBalancedDeep
100
VerticalBalancedHorizontal
100
LowBalancedHigh

Dynamic (movement)

100
NoneNormal
100
NoneNormal
100
NoneNormal
100
NoneNormal
100
EffacedBalancedDeep
100
VerticalBalancedHorizontal
100
NoneNormal

Synkinesis

100
SevereNone
100
SevereNone
100
SevereNone
100
SevereNone

Method

Each item is scored 0 to 100, where 100 is normal. Items that can deviate in two directions, such as a ptotic or overly elevated brow, are graded 0 to 200 and scored as 100 minus the distance from 100. Each subscore is the simple average of its items: static (5 items), dynamic (7 items), and synkinesis (4 items).

Rules from the original description: use the eFACE only for unilateral paralysis; grade synkinesis on the expression that produces the most severe synkinesis; if the nasolabial fold is effaced so that it cannot be seen, score both its depth and orientation as 0; with severe brow ptosis, estimate palpebral fissure width with the brow elevated manually.

The development study reports the three subscores and a regression relating them to expert-rated disfigurement, in which dynamic function weighed most heavily. It does not define a single total score, so none is shown here.

Source: Banks CA, Bhama PK, Park J, Hadlock CR, Hadlock TA. Clinician-graded electronic facial paralysis assessment: the eFACE. Plast Reconstr Surg. 2015;136(2):223e–230e. doi:10.1097/PRS.0000000000001447.

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