Hearing and speech are important means for human beings to communicate with each other and to understand the world, however, the gloom of ear diseases and hearing impairment is attacking human beings. According to the estimation of the World Health Organization, there are nearly 600 million people with mild hearing loss and 250 million people with hearing loss of moderate degree or above in the world. In China, there are 20.57 million hearing impaired people with disabilities, ranking first among all kinds of disabilities, which has seriously affected the improvement of the health level of all people. When mentioning about acoustic neuroma, people will think that this kind of tumor grows in the brain, and once it develops, it must be very serious. In fact, it is not, the disease of acoustic neuroma starts calmly and slowly, and the initial symptom is tinnitus, but the bad thing is that acoustic neuroma is very easy to be misdiagnosed or underdiagnosed. Early manifestations of acoustic neuroma are mainly unilateral, persistent, persistent tinnitus, and the treatment effect is not obvious, and hearing loss over time. This is a tumor compression of the nose and throat to see a doctor to find the cause, is considered to be a general hearing loss, or senile deafness. The symptoms of irritation caused by the auditory nerve are difficult to distinguish from ordinary tinnitus. Therefore, many patients with acoustic neuroma did not pay attention to the early stage, and one patient had tinnitus for ten years until he became deaf, which was diagnosed as acoustic neuroma. Early stage patients, especially middle-aged unilateral tinnitus patients, should consider the possibility of acoustic neuroma. Early treatment not only has a high rate of facial nerve preservation, but also has the potential to preserve hearing. Currently, the development of imaging is relatively rapid, especially CT, nuclear magnetic technology has become a reliable means of diagnosis of acoustic neuroma. Of course, middle-aged patients with persistent tinnitus do not have to go for CT or MRI right away, but can test the auditory conduction function first. This test is more economical, and further tests can be done if problems are found. Clinical manifestations Most cases of acoustic neuroma occur unilaterally. Although it develops slowly, it is adjacent to the brainstem and cerebral nerves, and as the tumor increases in size, it will lead to hearing loss, and ultimately loss of hearing; it will also show symptoms of brainstem or local cranial nerve invasion, such as dizziness, facial numbness, facial paralysis, cough weakness, difficulty in swallowing, and unsteady gait. Further development of the tumor may cause hydrocephalus. Once the intracranial pressure increases, it will lead to worsening headache, vomiting, vision loss, and even brain herniation, threatening the patient’s life. Optimal goal: total excision of the tumor + no damage to the facial and auditory nerves The current ideal treatment goal is total excision of the tumor and preservation of the facial and auditory nerve function. However, it is difficult to realize the optimal treatment goal. Different doctors and different patients have different perceptions of the goal of treatment of acoustic neuroma, and even for the same patient, it may be different depending on the technical level of the doctor and the choice of treatment method. Some patients, despite undergoing total surgical resection, suffer from complications due to the tumor being too close to the nerve, such as incomplete eyelid closure, exposure keratitis, varying degrees of dry eyes, and crooked mouths and eyes due to damage to the facial nerve. Some patients put the preservation of the facial nerve in the first place and do not agree to surgical total excision, thus failing to achieve the best therapeutic effect. We should adopt the appropriate treatment plan according to the specific situation of each patient, and strive to achieve the total removal of the mass and retain the facial and auditory nerve function, as for the cases that can not retain the facial and auditory nerve function can be repaired through the anastomosis of the facial nerve and the hypoglossal nerve. With the updating of surgical equipments and the improvement of surgeon’s technique and monitoring technology, the treatment effect is moving towards a more ideal goal. No damage to brain tissue + real-time monitoring = two keys to successful surgery In order to successfully perform an acoustic neuroma resection, in addition to a detailed preoperative examination, routine monitoring of facial, auditory nerve and brainstem function during surgery is one of the most important means of guiding the surgical operation. There are two key points in the surgery of acoustic neuroma: first, when removing the tumor, the brain tissue should not be damaged, and the natural gap of the brain tissue should be utilized to fully drain the water (cerebrospinal fluid), so that the brain pressure will drop, and then the tumor will be removed. The second is real-time monitoring to protect the function of the facial and auditory nerves, the trigeminal nerve and the brain stem. Once the monitoring shows that the operation is irritating them, the surgeon will pay extra attention in the next surgical operation. If the surgery is successful and there are no serious complications, the patient can work and live normally after about a month of rest. Regarding the recurrence of acoustic neuroma, very few recurrences have been found in cases with true total resection, including total removal of the mass in the internal auditory canal, through follow-up. However, patients with incomplete resection are at risk of recurrence. Message Middle-aged people with tinnitus and hearing loss should not ignore these seemingly non-serious symptoms, which may be the precursor of an acoustic neuroma. If the cause of tinnitus cannot be found in ENT department and treatment is not effective, further examination should be done as early as possible. Early detection and early diagnosis will greatly improve the treatment effect of acoustic neuroma, and the retention rate of facial and auditory nerves will be improved.