Facial muscle spasm, also known as facial muscle twitching, is characterized by irregular twitching of the facial muscles. The pathogenesis is still unclear, and the theory that can be widely accepted by the medical community is that the initial segment of the facial nerve exiting the brainstem has no myelin sheath and is prone to electrical activity when it receives compression from blood vessels and other structures, resulting in facial muscle twitching. The only effective treatment currently available is craniotomy for microvascular nerve decompression, where a special cotton sheet is used to isolate the facial nerve from the blood vessels compressing the nerve. Since the surgery was performed in the 1990s, the efficacy of the procedure has been precise, with an overall efficiency of over 90%. The surgical technique is relatively mature. Other treatments such as drugs and acupuncture are not suitable as the main treatment. In view of the relative maturity of the surgical technique, the focus of treatment has shifted to minimizing the surgical damage while the treatment is effective, and the surgical incision has now been reduced to 5cm in size, with only a 2cm size bone window, and the intracranial operation is performed under a microscope, with little damage and fast recovery. The incision has been reduced to 5cm in size and only a 2cm bone window is made.