During the past 15 years from 1980 to 1995, I have operated on 400 cases of acoustic neuroma with the keyhole microsurgery technique. Of 400 patients, 60 cases presented with preoperative usable hearing function with speech discrimination score better than 60% and with preserved wave V auditory brainstem response. In these 60 cases, total removal of the tumor and preservation of the cochlear nerve was attempted and postoperatively, serviceable hearing was preserved in 75% of the cases. Preservation of the facial nerve function was 98%. This videotape presents a representative 5 cases for radical resection of the vestibular schwannoma with preservation of the cochlear nerve.