With the advancement of technology, surgical procedures are gradually moving towards minimally invasive and hole-locking. Minimally invasive surgery does not just mean small incisions alone, it should be a philosophy: to complete surgery with minimal trauma. Therefore, minimizing surgical trauma is the basic principle of minimally invasive surgery, and preventing surgery-related complications is also a basic requirement of minimally invasive surgery. “Lock-hole surgery also does not mean that the size of the craniotomy is the same as that of the lock-hole, but it means that the individualized craniotomy has the function of a key to enter a specific intracranial space to obtain the best therapeutic effect with minimal trauma Instead, it is the choice of a direct and precise pathway that arrives at the lesion as noninvasively as possible, dispensing with the useless craniotomy portion of the conventional surgical access, without exposing the disease-free area, and the range of intracranial visual field should be expanded as the depth increases. Auditory neuroma is one of the three most common benign intracranial tumors. Once diagnosed, surgical treatment is the mainstay. In the past, the length of traditional surgical incision for acoustic neuroma was more than 10 cm, which was traumatic and unsightly. It is often necessary to remove part of the cerebellum or forcibly extract the cerebellum to enter the operation area and reveal the tumor, which will inevitably cause serious damage to the cerebellum. It is also prone to complications such as infection and cerebrospinal fluid leakage. With the advancement of minimally invasive microscopic techniques, we use the suboccipital hashaped sinus posterior locking hole approach to resect the acoustic neuroma, the incision is completely within the hairline, the length is only 5 cm, and the bone window is located in the transverse sinus, sigmoid sinus confluence, and the diameter is only less than 3 cm. The modern minimally invasive technique is to release the cerebrospinal fluid by opening the occipital pool, reduce the tension of the posterior cranial fossa, and then enter the operation area through the natural gap of the cerebellar margin after the cerebellum collapses, so that the tumor can be resected without damaging the cerebellum. Moreover, with intraoperative electrophysiological monitoring, it is not difficult to completely resect the tumor and complete the anatomical protection of the facial nerve. Hearing preservation in auditory neuroma surgery has become a new goal of modern minimally invasive neurosurgery. For large tumors, especially those involving the petrous apex, the ventral side of the brainstem and the superior cerebellar vermis, conventional surgery is prone to leave dead corners, and with the use of ventriculoscopy assisted surgery under minimally invasive, the deep microanatomical structures that are not in the straight line field of view of the microscope can be clearly seen, and the total excision of the tumor is conducive to the reduction of the pulling on the brain tissues at the same time. The specific advantages of suboccipital hashaped sinus posterior locking hole approach for resection of acoustic neuroma are as follows: 1, small craniotomy trauma, less blood loss: the skin incision, bone window area are significantly reduced, avoiding the ineffective craniotomy part. Due to the small scope of muscle incision, the blood loss during craniotomy and cranial closure is greatly reduced, and blood transfusion is generally not required. 2, shorten the operation time: the time for opening and closing the skull is less than half of the conventional operation time. 3, brain tissue damage is slight, fast recovery after surgery. 4. Fewer complications. 5.Significantly shorten the hospitalization time and reduce the hospitalization cost.