Birmingham Craniofacial Score: a scoring system for craniofacial deformities

A system was devised to score facial and head appearance in craniofacial patients in an attempt to quantify the severity of craniofacial deformities and measure the effect of corrective operations. It was deliberately kept simple to be "user friendly," and it must be regarded as incomplete. It has all the limitations of other scoring systems, but nevertheless it consistently reflects the results of operations, allowing quantitative comparisons and statistical analysis. It should be emphasized that deformity, not aesthetics, is measured. Fifteen features are scored. For every normal feature 1 point is awarded; for every abnormal feature, no point is scored. The range, therefore, extends from 0 to 15. In practice, there seems to be good correlation between the total score and the degree of deformity. A score of 13 or greater indicates that the appearance is cosmetically very good and the patient could be regarded as normal; a score ranging from 9 to 12 indicates a definite deformity; and a score of 8 or lower indicates the deformity is severe.