History of facial nerve surgery.

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.