Auditory neuroma is a slow-growing benign tumor that originates from the nerve sheath of the cranial nerve Schwann’s cell in VIII. It has a high incidence between 30 and 50 years of age, with no significant gender differences. The majority of cases are unilateral, and bilateral is also known as type II neurofibromatosis. Etiology and pathology] The etiology is unknown. Most of the tumors come from the vestibular nerve, so the disease is also called vestibular nerve sheath tumor. Most unilateral auditory neuromas are sporadic, while type II neurofibromatosis has a genetic abnormality on chromosome 22. Optical microscopy of auditory neuromas can be divided into two types: Antoni type A, the fascicular type, and Antoni type B, the degenerative or reticular type. The primary site of tumor is mainly in the internal auditory tract, with a few in the pontocerebellar horn of the cerebellum; as the tumor grows, the tumor in the internal auditory tract may protrude into the pontocerebellar horn. Clinical manifestations】 1. Hearing impairment The characteristic clinical symptoms of auditory neuroma are monaural hearing impairment, including deafness, tinnitus and auditory distortion. If the tumor is located in the pontocerebellar horn of the cerebellum, the symptoms will appear only when the tumor grows to a considerable size; while for tumors in the internal auditory canal, hearing impairment can appear at an early stage. Hearing loss can occur suddenly or gradually, and hearing loss can also improve temporarily. Therefore, hearing recovery of sudden deafness cannot completely exclude the possibility of auditory neuroma. 2. Vestibular symptoms Episodic vertigo or balance disorder is relatively rare, often manifested as gait instability. 3.Facial palsy Even if the tumor is very large, the symptoms of facial palsy are rare. 4.Other large tumors can cause facial pain and numbness by compressing the trigeminal nerve; in addition, large tumors can also show symptoms of brainstem compression or hydrocephalus. The degree of hearing damage and the time of appearance are related to the tumor site. Sensorineural deafness is dominated by high-frequency loss, with obvious decrease in speech resolution, normal otoacoustic emission, and prolonged latency and interwave period of auditory brainstem electrical response. 2.Vestibular function test The response to hot and cold stimulation test on the affected side decreases or disappears. 3.Imaging MRI is the main basis for the diagnosis of auditory neuroma. T1 image can show the soft tissue shadow of internal auditory tract or pontocerebellar horn, and the tumor is obviously enhanced after reinforcement. MRI is the gold standard for the diagnosis of auditory neuroma. Treatment】 1.Surgical treatment The surgical approach of auditory neuroma mainly includes transvagal approach, middle cranial fossa approach and posterior sigmoid sinus approach. The choice of surgical approach is related to the preoperative hearing and tumor size. The purpose of surgery includes complete removal of tumor, protection of facial nerve function and preservation of residual hearing as much as possible. 2.Radiotherapy Patients with poor general condition are not suitable for surgical treatment. 3.Observation Applicable to patients over 65 years old, tumor less than 0.5cm, no neurological symptoms, and MRI examination every 6 months.