BACKGROUND:Similarly with C-reactive protein, red blood cel distribution width can reflect the inflammatory process. Red blood cels involved in inflammatory process leads to the increase in red blood cel distribution width due to various inflammation factor receptors existingon the surface of red blood cel s. OBJECTIVE:To analyze the relationship between the neutrophils lymphocyte ratio, red blood cel distribution width and the pathogenesis andseverity of idiopathic facial paralysis. METHODS:The severity of idiopathic facial paralysis was assessed using the House and Brackmann Facial Nerve Grading System (HB) and Sunnybrook System (SB) in 30 included patients with idiopathic facial paralysis (disease group). The patients were graded as general (score 30-100) and severe paralysis (score 0-29) according to SB scores, or as mild (grade II/III), moderate (grade IV), severe paralysis (grade V/VI) according to HB grades. In addition, 30 healthy volunteers were selected as control group. Neutrophils lymphocyte ratio (NLR) and red blood cel distribution width (RDW) were compared between groups. The correlation of SB and HB scores with neutrophils lymphocyte ratio (NLR) and red blood cel distribution width was analyzed. RESULTS AND CONCLUSION:Neutrophils lymphocyte ratio was higher in the disease group than the control group (P< 0.01). A significant difference in red blood cel distribution width was found between different stages of disease severityin patients. Red blood cel distribution width was negatively correlated with SB scores (P< 0.01), while was positively correlated with HB grades (P< 0.01). Our results suggest that (1) neutrophils lymphocyte ratio is increased when idiopathic facial paralysis occurs; (2) red blood cel distribution widthis positively correlated with the severity of idiopathic facial paralysis, which indicates that inflammation is involved in the pathogenesis of idiopathic facial paralysis, and red blood cel distribution may be a marker for assessing the severity of idiopathic facial paralysis.

Facial nerve grading system (FNG) plays a crucial role in the diagnosis and treatment of idiopathic facial paralysis, and also serves as a primary tool for prognosis. Subjective grading systems are currently the most widely used methods due to their easy accessibility, popularization and low costs. Objective grading systems, which have obvious advantages in terms of index quantization, repeatability and consistency between evaluators, will become the mainstream in future application and possess development prospect despite their limitation of technology and cost. This article reviewd the clinical application of different types of FNGs in facial nerve grading among different periods, and made a summarization of currently-existing facial nerve grading methods. It may provide a scientific and reasonable reference to the constitution, filter and application of facial nerve grading systems in treating idiopathic facial paralysis.