Open Access
CC BY-NC 4.0 · Arch Plast Surg 2021; 48(03): 269-277
DOI: 10.5999/aps.2020.01844
Pediatric/Craniomaxillofacial/Head & Neck
Original Article

Computerized Sunnybrook facial grading scale (SBface) application for facial paralysis evaluation

Authors

  • Supasid Jirawatnotai

    Plastic and Reconstructive Surgery Unit, Department of Surgery, Lerdsin Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
  • Pojanan Jomkoh

    Plastic and Reconstructive Surgery Unit, Department of Surgery, Lerdsin Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
  • Tsz Yin Voravitvet

    Plastic and Reconstructive Surgery Unit, Department of Surgery, Lerdsin Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
  • Wuttipong Tirakotai

    Department of Neurosurgery, Prasat Neurological Institute, Bangkok, Thailand
  • Natthawut Somboonsap

    Department of Otorhinolaryngology, Buddhasothorn Hospital, Chachoengsao, Thailand

Background The Sunnybrook facial grading scale is a comprehensive scale for the evaluation of facial paralysis patients. Its results greatly depend on subjective input. This study aimed to develop and validate an automated Sunnybrook facial grading scale (SBface) to more objectively assess disfigurement due to facial paralysis.

Methods An application compatible with iOS version 11.0 and up was developed. The software automatically detected facial features in standardized photographs and generated scores following the Sunnybrook facial grading scale. Photographic data from 30 unilateral facial paralysis patients were randomly sampled for validation. Intrarater reliability was tested by conducting two identical tests at a 2-week interval. Interrater reliability was tested between the software and three facial nerve clinicians.

Results A beta version of the SBface application was tested. Intrarater reliability showed excellent congruence between the two tests. Moderate to strong positive correlations were found between the software and an otolaryngologist, including the total scores of the three individual software domains and composite scores. However, 74.4% (29/39) of the subdomain items showed low to zero correlation with the human raters (κ<0.2). The correlations between the human raters showed good congruence for most of the total and composite scores, with 10.3% (4/39) of the subdomain items failing to correspond (κ<0.2).

Conclusions The SBface application is efficient and accurate for evaluating the degree of facial paralysis based on the Sunnybrook facial grading scale. However, correlations of the software-derived results with those of human raters are limited by the software algorithm and the raters’ inconsistency.



Publication History

Received: 26 September 2020

Accepted: 24 February 2021

Article published online:
21 March 2022

© 2021. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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