Preservation of function in vestibular schwannoma surgery

The management and surgical technique for microsurgical tumor removal of vestibular schwannomas (acoustic neuroma) with the suboccipital retrosigmoid approach and semi-sitting patient positioning is described. An emphasis is placed on the preservation of auditory and facial nerve function with a stepwise description of the technical and operative nuances, including presurgical evaluation, positioning, anesthesiological and neurophysiological aspects, approach, microsurgical techniques, and postsurgical care.