ABSTRACT
The history of facial nerve surgery can be viewed as five overlapping periods, each
characterized by a new understanding or approach to the management of facial nerve
conditions. The first period, the period of discovery of the nerve of facial expression,
began with Sir Charles Bell's description in 1829 of 3 cases of facial paralysis due
to facial nerve trauma. The second period, from 1873 to 1960, was the era of facial
nerve repair. Decompression of the facial nerve was the primary focus of facial nerve
surgery in the third period, from 1908 to 1969. The fourth period, from 1970 to 2000,
can be characterized as the ``bottleneck'' period in honor of the contributions to
facial nerve surgery that resulted as Ugo Fisch and other surgeons sought ways to
operate on this portion of the proximal nerve. In the current or fifth, period in
the history of facial nerve surgery, we anticipate the advent of vaccines and antiviral
medications to minimize the sequelae of Bell's palsy, further improvements in endoscopic
equipment and techniques, and better surgical outcomes through the use of new technologies
such as robotics.
KEYWORD
Bell's palsy - cranial nerve decompression - facial nerve - middle fossa approach
