Microvascular decompression is a surgical method to separate the nerves and blood vessels that are compressed by each other, and it has become a highly recommended surgical treatment for facial spasm by neurosurgeons. The advantage is that the normal sensory and motor conduction functions of the facial nerve are preserved while the local vascular compression is removed and the symptoms are eliminated. Causes of facial muscle spasm The nerves and blood vessels in the skull are densely packed. If the nerves and blood vessels ride on each other, the pulsation of the blood vessels will cause the nerves to short-circuit, the excitability of the facial nerve will increase, and facial muscle spasm will occur. The blood vessel that compresses the nerve and produces pain is called the “responsible vessel”, and the common responsible vessels are: superior cerebellar artery, anterior inferior cerebellar artery, posterior inferior cerebellar artery, vertebral artery and so on. The responsible vessel can be one or multiple vessels, and it can be either an artery or a vein. Under general anesthesia, a 3-5 cm long surgical incision is made in the skin behind the ear, the cranial bone under the incision is ground down to about 2-3 cm in diameter, the facial nerve travel area is explored under the microscope, all the vessels and arachnoid cords that may produce compression are loosened, and these vessels are isolated from the nerve root by Tefflon spacers. Once the responsible vessels are isolated, the source of irritation disappears, and the hyperexcitability of the facial nerve disappears. In the majority of patients, the facial pain or spasm disappears immediately after surgery, and normal facial sensation and function are preserved without affecting the quality of life. The entire procedure takes about one to two hours. The advantages of microvascular decompression treatment Microvascular decompression is a method of treating the cause of facial spasm and preserving the anatomical integrity of these nerves. Because of its effectiveness, non-destructive nature, minimal side effects, and extremely low recurrence rate, microvascular decompression is currently the safest and most effective method internationally recognized for the treatment of facial myasthenia gravis. The most common surgical complications include loss of facial sensation, but with the improvement of microsurgical techniques, this complication is less than 5% in large neurosurgical institutions. The “double insurance” neurosurgical microscope, neurophysiological detector and hearing monitoring can clearly show the morphology of nerve roots, brainstem and vascular climbing without excessive stripping or traction, avoiding or reducing surgical complications and helping to confirm the compressed vessels. After decompression of the nerve root, the position and status of the blood vessels and the release of the nerve root can be confirmed endoscopically after the insertion of the decompression tampon, which makes it possible to find the responsible blood vessels for nerve compression extremely quickly and accurately, and also greatly reduces the damage to the auditory nerve and facial nerve during surgery. The possibility of hearing impairment and facial paralysis after surgery is greatly reduced.