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To compare the applicability of the grading scales. To compare patients\u2019 self-assessed facial palsy outcome results to gradings performed by the investigator. To compare the face-to-face assessed facial palsy outcome to the initial palsy grade.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifty-seven patients self-assessed their facial palsy outcome and came to a one-time follow-up visit. The palsy outcome was graded by one investigator using the three above-mentioned grading systems concomitantly. The median time from syndrome onset to follow-up visit was 6.6\u00a0years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Result<\/jats:title><jats:p>A good long-term face-to-face assessed palsy outcome was enjoyed by 84% of the patients. Trying to assess only one House\u2013Brackmann grade to represent the palsy outcome was impossible for most patients. Facial Nerve Grading System 2.0 worked better, but needed adjustments and certain sequelae findings needed to be neglected for it to be executable. The Sunnybrook system worked the best. Nearly 20% of the patients assessed themselves differently from the investigator: both better and worse.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The Sunnybrook scale was the most applicable system used. With antiviral medication, the outcome of facial palsy in Ramsay Hunt syndrome starts to resemble that of Bell\u2019s palsy and emphasizes the importance of recognizing the syndrome and treating it accordingly. The results give hope to patients instead of the gloomy prospects that have stigmatized the syndrome.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00405-020-06251-w","type":"journal-article","created":{"date-parts":[[2020,8,3]],"date-time":"2020-08-03T19:09:21Z","timestamp":1596481761000},"page":"1781-1787","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Ramsay Hunt syndrome: long-term facial palsy outcome assessed face-to-face by three different grading scales and compared to patient self-assessment"],"prefix":"10.1007","volume":"278","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9048-9043","authenticated-orcid":false,"given":"Mervi","family":"Kanerva","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanna","family":"Jones","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Pitkaranta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,8,3]]},"reference":[{"issue":"2","key":"6251_CR1","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1136\/jnnp.71.2.149","volume":"71","author":"CJ Sweeney","year":"2001","unstructured":"Sweeney CJ, Gilden DH (2001) Ramsay Hunt syndrome. 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