摘要随着医学的发展，外科手术也经历了由传统外科手术到微创手术，再到超级微创手术（SMIS）的发展和演变。伴随之，减少手术创伤、保留并重建神经功能也逐渐成为现代听神经瘤手术的新目标。听神经瘤切除手术根据患者术前是否具有实用听力分为保听术式（包括经乙状窦后入路和经颅中窝入路）和非保听术式（传统经迷路入路）。提高保听术式的听力保存率和重建非保听术式患者的听力是目前听神经瘤手术的热点和难点。传统的迷路入路术式在耳鼻咽喉头颈外科中占比最高，具有面神经保存率高、颅内并发症少的优势，但因常规切除蜗神经及迷路，术后耳蜗发生纤维化，患者将失去通过人工耳蜗植入重建听力的机会。新的改良迷路入路术式可保留耳蜗神经并有效减少耳蜗纤维化，为行人工耳蜗植入重建听力提供机会，是听神经瘤手术的又一重要突破。

abstractsWith the development of medicine, surgery has also experienced the development and evolution from traditional surgery to minimally invasive surgery, and then to super minimally invasive surgery (SMIS). Meanwhile, reducing surgical trauma and preserving and reconstructing nerve function have gradually become new goals of modern vestibular schwannoma (VS) resection surgery. The surgery of VS can be divided into hearing-preserving surgery (retrosigmoid approach and middle fossa approach) and non-hearing-preserving surgery (traditional translabyrinthine approach), according to whether the patient has practical hearing before operation. Improving the hearing preservation rate of hearing-preserving surgery and reconstructing the hearing of patients with non-hearing-preserving surgery are major challenges and hotspots. The traditional translabyrinthine approach has the highest proportion in the Department of Otolaryngology-Head and Neck Surgery, with the advantages of high facial nerve preservation rate and few intracranial complications. However, due to the resection of the cochlear nerve and labyrinth, the cochlea develops fibrosis, and patients lose the opportunity to reconstruct hearing through cochlear implantation. The new modified translabyrinthine approach can preserve the cochlear nerve and effectively reduce cochlear fibrosis, providing an opportunity for cochlear implantation to reconstruct the hearing. This is another important breakthrough in vestibular schwannoma surgery.