Microvascular decompression for intractable vertigo and tinnitus Neurosurgery Department of Jinan Military General Hospital Dr. Xue-Ming Lv, Chief Physician Neurosurgery Department of Jinan Military General Hospital Patients with vertigo and tinnitus are very common in clinical work, which seriously affects patients’ working life and many patients have poor results with medication. The surgical treatment of vertigo and tinnitus is attributed to Jannetta, a pioneer of modern cranial nerve microvascular decompression surgery for about 40 years. In the literature, the symptoms of cranial nerve VIII dysfunction are mainly vertigo, tinnitus, hearing loss, and possibly balance instability, nausea, and vomiting. The surgical improvement of these symptoms is most evident in the treatment of vertigo and tinnitus, with 80% of patients having good clinical results. For symptoms of hearing loss, microvascular decompression surgery is generally considered to have no clear therapeutic effect. Since the most important symptom that plagues these patients is vertigo, followed by tinnitus, cranial nerve VIII microvascular decompression surgery plays a positive role for patients suffering from these disorders, even if hearing cannot be improved. Patients with persistent vertigo and tinnitus should first choose medication, such as antidazzling, carbamazepine, valium, etc., and those with ineffective treatment or severe symptoms can choose surgery. The indications for surgery are: (1) Patients with unilateral intermittent vertigo and tinnitus, especially those with retroaural pain, hearing loss and facial muscle spasm. (2) Pre-operative comprehensive examination to exclude other systemic diseases causing vertigo and tinnitus; (3) MRI examination to exclude the occupancy of the pontocerebellar horn and the internal auditory tract, and 3D MRA to clarify the vascular compression of the VIII cranial nerve in the pontocerebellar horn segment; (4) brainstem auditory evoked potentials with II peak drop. The surgical method was auditory nerve microvascular decompression. It can develop in any part of the auditory nerve from the brainstem to the internal auditory tract, and it is more common in the external and external 1/3 segments of the auditory nerve. It has been found that simple vertigo: compression of the vestibular branch of the auditory nerve at the brainstem. Simple tinnitus: pressure on the cochlea of the auditory nerve. Balance disorder without vertigo: compression of the vestibular branch of the proximal brainstem auditory nerve. Vertigo with tinnitus: compression of the whole branch of the parabrachial nerve of the brainstem. Chief of Neurosurgery Department, General Hospital of Jinan Military Region Dr. Xue-Ming Lu, Chief of Neurosurgery Department, is in clinic all day every Wednesday.