What surgery for trigeminal neuralgia is the best?

MVD. Microvascular decompression to separate the nerve from the vascular structure (usually an artery or vein) pressing on it.
Consultation. Deciding the best surgery requires a careful surgical consultation including a high quality mri. Microvascular decompression, gamma knife radio surgery, balloon microcompression, and radio frequency gangliorhyzolysis are all good options.