目的：提高巨大型听神经瘤的手术全切率及面神经保留率，降低死亡率。方法：回顾性分析１６例巨大型听神经瘤的手术治疗，均采用枕下入路，其中８例行显微手术切除。结果：１５例全切，１例次全切，死亡１例，１０例出现面瘫，５例保留面神经，均为显微手术所致，显微手术的面神经保留率６２．５％。结论：合适的手术入路：术中予以侧脑室穿刺、体外引流及显微手术是巨大型听神经瘤手术成功的关键。 Objective: To improve the total surgical rate and facial nerve retention of giant acoustic neuroma and reduce mortality. Methods: Retrospective analysis of 16 cases of giant acoustic neuroma surgery, suboccipital approach, of which 8 cases underwent microsurgical resection. Results: Fifteen cases were totally resected, one case was totally resected, one case died, 10 cases had facial paralysis, and 5 cases had preserved facial nerve. All cases were caused by microsurgery. The facial nerve retention rate was 62.5%. Conclusion: Appropriate surgical approaches: Intraoperative lateral ventricle puncture, external drainage, and microsurgery are the keys to the success of giant acoustic neuroma surgery.