Some foreign scholars have proposed the concept of “VIII cranial nerve vascular compression syndrome”, which means that some patients’ symptoms can be caused by the compression of the 8th cranial nerve by vascular collaterals in the pontocerebellar horn region. In these patients, if conventional treatment is not effective, they can be treated by microscopic minimally invasive neurovascular decompression, which aims to release and relocate the responsible vessels compressing or stimulating the 8th cranial nerve. In more than 80% of these patients, good results can be achieved. The use of surgical methods to treat vertigo and tinnitus is attributed to Jannetta, a pioneer in modern cranial nerve microvascular decompression surgery for about 40 years. in the surgical treatment of trigeminal neuralgia and facial spasm, Jannetta discovered the correlation between vascular compression of cranial nerve VIII and symptoms of cranial nerve VIII damage (e.g., vertigo, tinnitus, hearing loss), and applied microvascular decompression We have also applied microvascular decompression to the clinical treatment of this disease. Patients with persistent vertigo and tinnitus should be treated with medications such as antivertigo, carbamazepine, and valium, etc. If the treatment is ineffective or the symptoms are severe, surgery is an option. The indications for surgery are: (1) Patients with unilateral intermittent vertigo and tinnitus, especially those with retroaural pain, hearing loss and facial muscle spasm. (2) Pre-operative comprehensive examination to exclude other systemic diseases causing vertigo and tinnitus; (3) MRI examination to exclude the occupancy of the pontocerebellar horn and the internal auditory tract, and 3DMRA to clarify the vascular compression of the VIII cranial nerve in the pontocerebellar horn segment; (4) Brainstem auditory evoked potentials with peak II decrease. The surgical method is auditory nerve manifest microvascular decompression: compression by any part of the auditory nerve from the brainstem to the internal auditory tract can develop, with the external and external 1/3 segments of the auditory nerve being the most common. It has been found that simple vertigo: is a compression of the vestibular branch of the auditory nerve in the brainstem parietal. Simple tinnitus: pressure on the cochlea of the auditory nerve. Balance disorder without vertigo: compression of the vestibular branch of the proximal brainstem auditory nerve. Vertigo with tinnitus: compression of the whole branch of the parabrachial nerve of the brainstem. Surgical efficacy According to the literature, the symptoms of cranial nerve VIII dysfunction are mainly vertigo, tinnitus, hearing loss, and may be accompanied by balance instability, nausea, and vomiting. The surgical improvement of these symptoms is most evident in the treatment of vertigo and tinnitus, with 80% of patients having good clinical results. For the symptoms of hearing loss, MVD surgery is generally considered to have no clear therapeutic effect. Since the most predominant symptom plaguing these patients is vertigo, followed by tinnitus, cranial nerve VIII microvascular decompression surgery plays a positive role for patients suffering from these disorders, even if hearing cannot be improved.