Craniotomies for acoustic neuroma include suboccipital-endocardial approach, transcranial middle fossa approach, and transvaginal approach. 1. Suboccipital-endocardial access surgery: after revealing the endocardial canal by suboccipital approach, the posterior lip of the endocardial canal is abraded to form the surgical access. The bone window is usually located in one side of the suboccipital. After clipping the dura mater, the cerebellar medullary pool cerebrospinal fluid is released. Different ways of separating the tumor are used depending on the size of the tumor. During the operation, attention is paid to the preservation of facial nerve and the preservation of hearing. 2. Transcranial middle fossa approach: the patient is in supine position. An “S” shaped incision is made on the anterior temporal arch of the ear. The bone window is located 2/3 in front of the external auditory canal and 1/3 behind the external auditory canal, near the base of the middle cranial fossa. The bone in the upper area of the internal auditory canal is abraded to reach the dura mater of the internal auditory canal, revealing the dura mater inward and exposing the facial nerve canal opening. Surgery is performed in front of the tumor, which is conducive to separating and protecting the facial nerve. 3. Translabyrinthine approach: limited to small acoustic neuromas. An incision is made behind the ear, and the labyrinthine bone is abraded to reach the internal auditory canal, and the tumor in the internal auditory canal is resected. This procedure has a high rate of facial nerve preservation, mild reaction of the patient, and quick recovery. However, it can also result in complete loss of hearing postoperatively due to disruption of the labyrinth and a higher incidence of cerebrospinal fluid leakage. For patients diagnosed with acoustic neuroma, they should go to the relevant departments of regular hospitals as soon as possible, and under the guidance of professional physicians, in order to avoid delaying the condition and causing adverse consequences.