MVD surgery is currently the preferred surgical treatment for primary trigeminal neuralgia, first proposed by Prof. Jannetta in 1967, and the indications for surgery include: those who are confirmed to have vascular compression of the trigeminal nerve by imaging; those who are willing to undergo surgery due to poor results of other treatments; and those who are willing to undergo surgery due to painful vessels compressing the trigeminal nerve, called “responsible vessels”. The vessel that compresses the trigeminal nerve and produces pain is called the “responsible vessel”. Under general anesthesia, a 4-cm longitudinal incision is made behind the affected ear, inside the hairline, and a hole is made in the skull, about 2 cm in diameter. Once the responsible vessels are isolated, the source of irritation disappears and the hyperexcitability of the trigeminal nucleus disappears and returns to normal. In the vast majority of patients, the pain disappears immediately after surgery and normal facial sensation and function are preserved without compromising quality of life. (1) manifestation of typical trigeminal neuralgia with the presence of “trigger point”; (2) exclusion of inflammation and CPA tumor; (3) drug tolerance, toxic side effects, and poor efficacy; (4) less than 70 years old, no serious organic disease, and able to tolerate surgery; (5) unable to accept facial numbness after other treatments; (6) preoperative cranial MR examination (7) the patient has the intention to operate; the main reason for recurrence is postoperative adhesions. In other words, the surgery is supposed to release the compression of the nerve by the blood vessels, but because some of the intracranial structures can become adherent after surgery, it may bring the blood vessels close to and irritate the nerve again, leading to pain recurrence. In addition, there are some objective factors that can affect the outcome of the surgery. Every body structure is not exactly the same, and this is especially true for blood vessels and nerves. With surgery, we hope to keep the blood vessels away from the nerves, but some patients have particularly small intracranial spaces or other abnormal structures, which can affect the outcome of the surgery, resulting in unsatisfactory results or postoperative recurrence.