Microvascular decompression surgery is the best way to treat facial spasm and trigeminal neuralgia, there is no special preparation before surgery, mainly the following points need to be noted: 1, intraoperative treatment of the rock vein should be careful, the current of bipolar electrocoagulation should be gradually changed from small to large until the rock vein is completely electrocautery occluded before cutting off, avoiding hemorrhage caused by the rock vein being burnt by too much current during electrocoagulation. 2, Teflon cotton group is generally padded on the near brainstem side of the vessel, so that the vessel leaves the trigeminal nerve root, minimize the contact between Teflon cotton group and trigeminal nerve root, and pay attention to the placement of Teflon cotton group must be firmly, to prevent slippage and displacement. 3, Intraoperative care should be taken to carefully explore the dorsal and ventral sides of the trigeminal nerve root to clarify whether there are multiple vessels compressing it, and if there are multiple “responsible vessels”, they should be decompressed to avoid omission. 4. If no clear vascular compression of the trigeminal nerve root is found intraoperatively, or if there is vascular compression but satisfactory decompression is not possible, the posterior lateral 3/4 of the sensory root of the trigeminal nerve can be cut. For those who have unsatisfactory pain relief or recurrence after trigeminal nerve root microvascular decompression, partial dissection of the trigeminal sensory roots can also be performed again. In addition to the perfect technical level of the surgeon during surgery, the cooperation of the patient after surgery is also very important for the cure of the disease. Patients should cooperate with the medical staff after surgery, strictly comply with medical advice, and respond to any discomfort symptoms in a timely manner. Do not delay treatment and serious consequences.