Once the diagnosis of facial spasm is confirmed and the medical treatment is not effective, surgery should be an option. The surgery is minimally invasive, a small incision is made behind the ear, about 5-6 cm long, and a small window has to be opened in the skull, this window has a skull diameter of about 2.5 cm. After the surgery, the skull needs to be put back and the skull is fixed with titanium nails, which will not affect the integrity of the skull. The surgery is performed under a microscope, dissecting from the natural interstices of the body, without damaging the brain tissue, and finding the position of the facial nerve just out of the brainstem, the blood vessel that is compressing the facial nerve can be found. The surgery is performed by pushing the vessel collaterals out of the way, and a spacer is placed between the vessel and the nerve to prevent the return of the vessel causing this compression to recur. The disappearance of the “abnormal electromyographic response” is the “gold standard” for determining whether or not to pad the vessel and release the facial nerve compression.