Primary trigeminal neuralgia (PTN) is a common and frequent disease in functional neurosurgery, mainly manifested as recurrent episodes of severe paroxysmal pain in the distribution area of the trigeminal nerve, with discharge-like episodes lasting from a few seconds to a few minutes each time, or from tens of minutes to hours, with normal intervals, and some patients with severe disease may have no obvious intervals. It is often called the first pain in the world. The pain is usually located in the 2nd and 3rd branches of the trigeminal nerve, mostly in middle-aged and elderly people, and is more common in women, and most of them are unilateral. Etiology and pathogenesis: At present, the “vascular compression theory” of primary trigeminal neuralgia has become a widespread definitive understanding, which believes that the pulsating arterial blood vessels compress the trigeminal nerve REZ zone (nerve fiber exposure zone) and cause pain attacks. Most patients take oral carbamazepine and other drugs as the initial treatment choice. As the disease progresses, the efficacy of the drugs gradually decreases, and patients increase the dose or number of doses to control pain attacks. Other non-mainstream surgical methods, such as: glycerin (anhydrous alcohol) injection destruction, radiofrequency electrocoagulation destruction of the meniscus, trigeminal nerve peripheral branch avulsion, etc., the above procedures are invasive treatment, all at the cost of nerve damage, almost all have side effects, easy to recur and other shortcomings. Stereotactic radiation therapy, such as gamma knife, although minimally invasive, less painful, can be applied to older, combined with hypertension, diabetes, coronary heart disease and other diseases or the existence of other surgical contraindications, can not tolerate the operation of the faithful, but the effect is slow, there is still some damage to the nerve, facial numbness, burning sensation, slavery, chewing muscle function decline and other complications. Microvascular decompression: Dandy proposed the theory of trigeminal nerve compression in 1932, which was mainly caused by vascular compression, and also described the pathological abnormalities such as demyelination of the nerve compression site. At present, Tefflon cotton mass thermal compartment microvascular decompression has become the treatment of choice for drug-refractory primary trigeminal neuralgia because of its mature technology, minimally invasive, rapid results, precise efficacy, low recurrence rate, and fewer and less severe complications than other treatments.