Trigeminal nerve microvascular decompression refers to the use of surgical methods to separate the compressed blood vessels from the trigeminal nerve, thus achieving the purpose of relieving pain, and is currently the preferred method for the treatment of primary trigeminal neuralgia. Its advantage is that it targets the main cause of trigeminal neuralgia, and after removing the compression of the nerve, the pain can completely disappear in more than 95% of patients, and the facial sensation is completely preserved, which is the only treatment method that can achieve a true and complete cure of trigeminal neuralgia. Surgical method: After shaving the head (or only the local hair behind the ear can be shaved), under general anesthesia, a straight incision of about 4 cm in length is made behind the ear on the painful side, a circular bone window of about 2 cm in diameter is created, the responsible blood vessel compressing the root of the trigeminal nerve is found under the microscope, and Teflon cotton is placed between the trigeminal nerve and the responsible blood vessel to achieve the purpose of treatment. The defective bone window can be repaired immediately with titanium mesh without affecting the postoperative aesthetics. Microvascular decompression is also the treatment of choice for facial spasm and is the only standard method that may provide a radical cure for facial neuropathy, unlike the treatment of trigeminal neuralgia where the Teflon pad opens the responsible vessel to the facial nerve rather than the trigeminal nerve.