목적: Typically, Bell's palsy is most prevalent in middle-aged individuals, around the age of 40, regardless of region or country. However, there are patients in their 20s or 30s who have already experienced Bell's palsy 3 to 7 times well before the age of 40. These individuals, regardless of underlying medical conditions or family history, endure multiple episodes of facial paralysis at a young age, resulting in severe sequelae.Although performing facial nerve decompression surgery in severe cases of Bell's palsy remains a controversial topic, I have conducted preventive facial nerve decompression surgery over the past decade on patients who experienced Bell's palsy at least five times before the age of 40. The primary goal was not to improve the existing facial sequelae but to prevent future occurrences of facial paralysis. 방법:From 2015 to December 2024, a total of 34 patients underwent preventive facial nerve decompression surgery. All procedures were performed using the transmastoid approach, with extensive removal of the bony tissue around the geniculate ganglion and maximal widening of the labyrinthine segment to the medial side to relieve pressure on the facial nerve. The average age of the patients at the time of surgery was 32.4±5.3 years, with an average of 3.7±1.22 episodes of facial paralysis. Most patients exhibited chronic geniculate ganglionitis during surgery, with no other notable findings. 결과:Among these patients, 27 are being followed up, with an average follow- up period of 4.4 years. Seven patients are not being followed up, and no recurrences have been observed in the patients currently under observation. 결론:Preventive facial nerve decompression surgery may be considered to minimize sequelae in patients who frequently experience Bell's palsy from a young age.