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; the blood vessel that compresses the trigeminal nerve and produces pain is called the “responsible vessel”. The vessel that compresses the trigeminal nerve and produces pain is called the “responsible vessel”. Microvascular decompression is performed by making a 4 cm longitudinal incision behind the affected ear and in the hairline under general anesthesia, making a cranial hole with a diameter of about 2 cm, entering the pontocerebellar horn area under a microscope, exploring the trigeminal nerve travel area, “loosening” all the vessels and arachnoid cords that may produce compression, and isolating these vessels from the nerve roots with a Tefflon spacer. Once the responsible vessels are isolated, the source of irritation disappears, and the hyperexcitability of the trigeminal nucleus disappears and returns to normal. The vast majority of patients experience immediate postoperative pain disappearance and retain normal facial sensation and function 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 suggests that the trigeminal nerve root is closely related to the adjacent peripheral vessels; (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 vessel, but because some of the intracranial structures can become adherent after surgery, it may bring the blood vessel 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 want 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.