Nowadays smaller acoustic tumors are being detected earlier. We started to remove these tumors with attempt of preservation of hearing in 1994. Since 1994, in an attempt to preserve hearing, the retrosigmoid approach was used. Our first results are presented and criteria of preoperative selection and postoperative evaluation are discussed. A fair chance to keep a useful hearing can be given to a patient with a small tumor, preferrably smaller than 1,5 cm and provided that the average hearing levels differ by no more than 30 dB from the other ear. In all the other cases the translabyrinthine route remains the preferred approach.