Facial myospasm is not life-threatening, but it affects the patient’s quality of life and self-esteem. If not treated thoroughly, it will be accompanied by lifelong, and it will also slowly worsen, and facial atrophy may even occur if facial myospasm worsens. The only way to cure facial myospasm – microvascular decompression – is a minimally invasive surgery to completely solve the disease. The detailed procedure is as follows: 1. Removal of hair from the surgical area: The nurse will remove a portion of the hair behind the patient’s ear before surgery in order to expose the surgical field. If the patient has short hair, especially if he is a male, it is not a big deal to remove all the hair and the hair will grow back after some time after the surgery. 2. Incision behind the ear: Microvascular decompression surgery involves cutting a small, long opening in the occipital area behind the ear, either horizontally or vertically. The horizontal incision is generally preferred because it is smaller, usually 4 cm; the vertical incision is a little longer because it involves more of the surrounding muscles. The advantage of the incision behind the ear is that the hair will cover the incision area after the surgery. 3. Removal of a bone flap the size of a dollar coin: The skin behind the ear is cut open, muscle or blood vessels and other tissues are separated, the occipital bone at the brain shell is exposed, and then a special surgical instrument, a grinding drill, is used to drill several small incisions in the occipital bone, and then a small piece of the occipital bone is cut off here with a scalpel – about the size of a dollar coin. -The bone flap is about the size of a dollar coin, and the small piece of bone flap can be uncovered to access the facial nerve and the surrounding blood vessels. 4. Finding the facial nerve and the blood vessels involved: Since there are many nerves and blood vessels in the cranial brain, finding the facial nerve and the blood vessels involved depends not only on a special preoperative MRI, but also on the surgeon’s surgical experience and skill. There are 12 pairs of nerves running through the brain, symmetrically distributed, and each pair of nerves has its own special way of travel. Under the microscope, the surgeon has to carefully find the facial nerve. Since the nerves are flexible, if they are simply picked up with surgical instruments, when the instruments are removed, the facial nerve will spring back to its original position and the patient’s facial spasm symptoms will remain unrelieved, so it is easy to relapse. Therefore, it is necessary to use special shock-absorbing materials to separate the two. After the separation, the pulsation of blood vessels will not directly stimulate the facial nerve, thus achieving the purpose of curing facial muscle spasm. 5.Special spacer to separate the blood vessel and nerve: find the facial nerve and the offending blood vessel in the skull, and use a special material Teflon spacer (sponge pad) to separate the blood vessel and the nerve. The sponge pad has a shock-absorbing and cushioning effect that minimizes the irritation of the facial nerve by the pulsating blood vessels. Moreover, the spacer is not easily absorbed or displaced, and it can work all the time after implantation to effectively prevent recurrence. It is like two people arguing and the spacer acts as a puller. The spacer is usually placed in 1-3 pieces, and since the spacer itself is very soft, there is no need to worry about compression of blood vessels or nerves. Finally, the bone flap can be reset again to ensure the integrity of the cranial structure. These steps look simple, but in practice, they test the surgeon’s surgical skills, adequate preoperative preparation, and accurate intraoperative monitoring. Doing these three things can minimize the trauma and improve the healing rate.