Facial muscle spasm, also called facial twitching, hemifacial spasm, is mainly an involuntary twitching of one side of the face, firstly manifested as a twitching of the muscles around the eyes, with the patient blinking involuntarily, and then gradually developing to the ipsilateral cheek, this twitching is not accompanied by pain, and can be aggravated by fatigue and tension, especially obvious when speaking and smiling, and in severe cases can be in spasm. Trigeminal neuralgia is one of the most common facial pain syndromes. The pain can be triggered by activities such as brushing teeth, talking, washing face, eating, etc. The pain is intense, like a pinprick, and unbearable, which seriously affects the patient’s work and life. Microvascular decompression is performed by making a 5-6 cm long skin incision on the posterior side of the ear, within the hairline, under general anesthesia, and then drilling a small hole in the skull, about 2.5 cm in diameter, to access the area of microvascular compression under a microscope. These vessels are then removed so that they are not in contact with the nerve. A special material called Teflon spacer is then used to isolate the nerve from the vessels, which does not interfere with the nerve root and will not be absorbed, and the procedure is completed. Microvascular decompression is the only method to treat the cause of the disease, therefore, it is the treatment for trigeminal neuralgia and facial spasm that is highly respected and widely used by the majority of scholars at home and abroad, and its advantage is that it is effective in solving facial pain or facial twitching on a long-term basis and maintains the anatomical integrity of the nerve, thus maintaining normal nerve function, changing the facial dysfunction and improve the patient’s quality of life.