The authors the case-record of a female patient with a neurinoma of the acoustic nerve which was successfully operated by a translabyrinthine approach and they discuss ontoneurological issues associated with this problem.The translabyrinthine approach to a neurinoma of the acoustic nerve makes a very effective clear approach to the tumour possible, in particular as regards visualization of the facial nerve throug- hout, the operation. It provides adequate orientation in the cerebro-cerebellar angle. If necessary, the approach can be extended and thus the size of the tumour is not a limiting factor of the surgical procedure. The authors describe pitfalls in case of an amply pneumatized bone which involve the danger of opening of the sinus tympani and inadequate tamponade of the attic at the end of the operation. The first danger was overcome in the described case. Perfect closure on the defect of the dura mater, filling of the trepanation cavity and tamponade of the attic was achieved only by two strips of adipose tissue from the hypogastrium and by extraction of the incus. The patient has no innervation lesion of the facial nerve and during the 2.5 year follow up after surgery there are no signs of relapse of the tumour.

        Key words: neurinoma of the acoustic nerve, translabyrinthine approach.