Background: Advances in various diagnostic and/or treatment modalities, including radiological imaging, neuromonitoring, and microsurgical techniques, have resulted in treatments of vestibular schwannomas being aimed at preserving facial and hearing functions while achieving optimal tumor control.
Method: We describe our surgical technique for hearing preservation in vestibular schwannoma surgery.
Conclusion: The retrosigmoid transmeatal approach under continuous neuromonitoring (auditory brainstem response, cochlear nerve action potentials, and continuous facial nerve monitoring) enables gross-total resection of vestibular schwannomas, while preserving hearing and facial functions. Radiological assessment and microsurgical techniques, such as meticulous tumor dissection, are also essential for functional preservation with sufficient tumor removal.
Keywords: Acoustic neuroma; Cerebellopontine angle tumor; Internal acoustic meatus; Lateral suboccipital approach; Neuromonitoring; Skull base surgery.