Cranial nerve compression syndrome is a group of diseases Cranial nerve compression syndrome is a group of functional neurological diseases, including facial muscle spasm, trigeminal neuralgia, glossopharyngeal neuralgia and spastic squint caused by the 11th pair of cerebral nerves. Trigeminal neuralgia is a lightning-like, paroxysmal tearing pain that lasts for several seconds and is confined to one side of the face in the distribution area of the trigeminal nerve; linguopharyngeal neuralgia is a paroxysmal tearing pain in the distribution area of the linguopharyngeal nerve and vagus nerve, with the pharynx and base of the tongue most often involved. It may radiate to the skin behind the ear and the neck; while spastic squint caused by the 11th pair of cerebral nerves presents with lateral movements of the head (transverse type), worsened by supine lying (unlike cone systemic squint), with contraction of the sternocleidomastoid muscle usually accompanied by activity of the contralateral antagonist. The incidence of this type of disease is low, and in addition to the typical clinical manifestations, more importantly, it has a serious impact on the patient’s work, study and life, even resulting in more severe tension, anxiety, depression, and severe sleep disturbances, leading to a significant decrease in quality of life. The microvascular decompression surgery has immediate effect The research of domestic and foreign authorities shows that the cause of cranial nerve compression syndrome, since Jennatta proposed the vascular neurological conflict science, confirmed that the microvascular pressure from the cranial nerve out of the brainstem region (REZ) accounted for more than 90%-95%, of which the responsible arterial vascular accounted for 85-90%. Except for intracranial tumors, intracranial infections, craniocerebral trauma and other causative factors, all are idiopathic diseases. Microvascular decompression (MVD) has become the recognized treatment of choice for cranial nerve compression syndrome because of its small trauma, precise efficacy, high cure rate, low complications, and especially its characteristics of preserving vascular and neurological functions. The Department of Functional Neurology, Beijing Haidian Hospital, has been following the classical MVD procedure, based on which routine intraoperative electrophysiological monitoring, straight incision, small bone window, minimizing the use of brain plates and bipolar electrocoagulation, using separation of the arachnoid membrane of the brain pool, releasing cerebrospinal fluid, changing the angle of body position, adjusting the depth of field and perspective of the microscope, and operating from the natural gap of cerebellar collapse, basically without exposing the compressed cranial nerves. Since there are more small penetrating arteries in the REZ and on the surface of the brainstem with short stroke, thin diameter and complex shape, they are often important sources of nourishing blood supply to the brainstem, which makes it more difficult and dangerous to push the responsible vessels and place the cushioned cotton for these microscopic operations, minimizing the strain on the compressed cranial nerves and the provocation of the small penetrating arteries to achieve the purpose of real minimally invasive surgical treatment. At the same time, the application of the medical adhesive vascular suspension technique of the skull base dura for the thicker responsible vessels and more complex multi-branch compressed responsible vessels increases the cure rate of cranial nerve compression syndrome, reduces the risk of postoperative complications, and effectively reduces the chance of postoperative recurrence. The preliminary summary of 216 cases of facial myoclonus in the front department has a cure rate of 87.04%, with a delayed cure rate of 10.19% and a total effective rate of 96.76%, which has achieved good surgical results, and the surgery can be said to have an immediate effect. Intraoperative electrophysiological monitoring is indispensable With the rapid development of intraoperative electrophysiological monitoring technology and its wide application, intraoperative electrophysiological monitoring technology has become an integral part of functional neurosurgery at home and abroad. Intraoperative monitoring can provide patients with real-time status about cranial nerve function and dynamic changes of neurophysiological signals, which is helpful for the operator to take necessary measures to avoid important nerve structures, avoid surgical risks and reduce unnecessary cranial nerve injuries, and is a good indicator to evaluate and judge the effect of MVD decompression. The electrodes are placed on the orbicularis oculi, orbicularis orientalis or superior labialis when monitoring the facial nerve function, on the masticatory muscle when monitoring the motor branch of the trigeminal nerve, and on the oblique muscle when monitoring the collateral nerve. In our department, we routinely monitor the lateral spread response (LSR), which is a characteristic electrophysiological manifestation in patients with idiopathic facial spasm (HFS). Some foreign scholars also perform intraoperative monitoring of brainstem auditory evoked potentials (BAEP) in conjunction with lateral diffusion response (LSR) monitoring and domestic scholars perform intraoperative abnormal muscle response (AMR) monitoring in conjunction with intravenous and inhalation-based anesthesia, and no intraoperative inotropic maintenance is given without special circumstances except for tracheal or laryngeal mask intubation to ensure the effectiveness of monitoring. Through intraoperative electrophysiological monitoring, the efficacy of MVD surgery has been greatly improved. Nearly 1,000 successful cases in five years The Department of Functional Neurology of Beijing Haidian Hospital is a relatively young department. In the past five years since the establishment of the department, nearly 1,000 MVD surgeries have been completed, with a cure rate of 85.40% and an overall efficiency of 94%, including cases of trigeminal neuralgia, facial spasm, glossopharyngeal neuralgia, neurogenic hypertension and spastic diastasis, among which 12% are elderly cases >60 years old. The clinical results of 216 cases of facial spasm have been analyzed, and the surgical results are more satisfactory, and the follow-up work and case summary are in progress in the later stage. New exploration of classical surgery Through the surgery of cranial nerve compression syndrome, we found some new cases, such as: facial spasm, lingual neuralgia or trigeminal neuralgia patients with hypertension at the beginning of the disease, after MVD surgery, the clinical symptoms disappeared, and the blood pressure was well controlled and basically reached normal level, some patients have stopped taking antihypertensive drugs; spasticity caused by the 11th pair of cerebral nerves For the treatment of neurogenic hypertension, we are exploring the possibility of MVD to solve patients’ intractable vertigo and tinnitus. These patients have achieved good results in the near future, but the long-term results are still in the process of close follow-up. The classical microvascular decompression surgery has been given a new vitality and new exploration, which will surely bring more treatment tools to the majority of patients, relieving their pain and returning their health. Eliminate clinical symptoms and pay attention to the quality of life at the same time The group of patients suffering from cranial nerve compression syndrome is more complicated, most of them are middle-aged people with social activities, slightly more female patients than male, and most of them are the backbone of families and social groups, including lawyers, teachers, unit department leaders, corporate employees, farmers …… due to The disease is ashamed to participate in social activities or work, there is a huge mental pressure and life pressure, over time there is more serious anxiety, depression, sleep quality decreased, the quality of life significantly reduced. Therefore, in all patients admitted to the hospital, attention should be paid to psychosomatic, neuropsychological, sleep quality and quality of life. Patients who visit our department routinely undergo systematic assessment of psychosomatic, neuropsychological and quality of life, and quantify the indicators. While surgically relieving patients’ clinical symptoms, we gradually and progressively intervene to improve the psychological state of tension, anxiety and even depression, and adjust the quality of sleep through short-term stepwise pharmacotherapy treatment, so as to cure the disease and at the same time really improve patients’ quality of life, so that they can stand up again, participate in social activities, return to work, and be recognized and respected. Therefore, a full range of treatment is the key to a complete cure, and we are not only concerned about the disease itself, but also about the quality of life and livelihood.