Total tumor resection and nerve function protection are unified and contradictory, when the contradiction occurs, which side should we choose? In the case of auditory neuroma, the goal of surgery is to achieve complete resection of the tumor and good protection of the facial nerve. A colleague once observed a surgery abroad, and a world-renowned professor felt unsatisfied with the neurological monitoring during the surgery and left after half of the tumor was removed. Nerve damage after trigeminal nerve sheath tumor surgery can lead to different manifestations. Occurring in the ophthalmic branch will lead to abnormal eye sensation, difficulty in tear secretion, corneal ulcer and finally blindness; occurring in the maxillary branch will make the maxillofacial sensation numb, occurring in the mandible besides cheek numbness, chewing will also be affected, no energy for eating, and always biting the cheek without knowing it. If it occurs in the trigeminal nerve trunk, all three of the above symptoms may occur. The surgery was very successful, but after the surgery, the old lady was not comfortable and often asked her nurse’s daughter to come to Beijing for a review, which shows that the nerve function was indeed damaged despite the successful removal of the tumor. With the current surgical technology, total removal of the trigeminal nerve tumor is no longer a problem, but the protection of each trigeminal nerve is still a challenge, and it is the invisible nerve damage (unlike post-operative facial palsy from an audioma, which can be seen at a glance) that needs to be addressed.