Last week, we operated on a 48-year-old patient with a large tumor. We used CTV to accurately locate the transverse sinus and sigmoid sinus and then used a CPA angular approach to completely resect the tumor. I think all surgeons can understand this state of mind: it is still difficult to preserve facial nerve function in large audiomas, especially in the acute stage. Today the patient was discharged from the hospital and I would like to share my views on the treatment of auditory neuroma. I have always been a strong advocate of surgery, not to say that the gamma knife is not useful at all, there are some special circumstances, such as advanced age, the patient’s condition, etc., when surgery is not suitable, the gamma knife provides us with a good choice. But if the situation allows, I will still give the patient a very firm recommendation: surgery. Because surgery can fundamentally remove the tumor, and a good neurosurgeon should still have some confidence in preserving the facial nerve, especially for solid audiomas under 3 cm. On the contrary, gamma knife seems to have no loss, but firstly, it only inhibits the growth of the tumor, rather than fundamentally removing the tumor, secondly, it seems to effectively preserve the facial nerve, but I often see patients with facial paralysis after gamma knife treatment in the clinic, especially that kind of small tumor, I think the possibility of preserving facial nerve function by surgery for this kind of tumor is still quite high; thirdly, if the rebound after gamma knife treatment I have encountered a series of such patients, the effect is very poor. This is an “intuitive and simple” point of view in my work, this year read an article in our top academic journal of neurosurgery, this article is the best hospital in the United States Hopkins Medical School summarized their own experience and analyzed the results of gamma knife treatment of other units of auditory tumors, a total of more than 1000 patients. They ended up with a similar conclusion regarding the treatment options for auditory neuroma: in large medical centers, experienced neurosurgeons should still prefer surgical treatment; in smaller hospitals, surgical results may not be as good as gamma knife because of the inexperience of the doctors. Therefore, they recommended that patients with auditory neuromas should still seek treatment from experienced physicians at large neurosurgical centers.