Surgical removal is the management option of choice for the vast majority of ANs.
The priorities in AN surgery are first the preservation of life, second the maintenance of facial nerve function, and third the preservation of socially useful hearing in the tumor ear. Among these, the first is nearly always achieved, the second is obtained with regularity, and the latter goal is seldom realized. AN surgery may be performed by either a neurotologist or neurosurgeon alone, but many centers have found that collaboration between the two specialties is desirable as this takes best advantage of the special skills possessed by each. Another factor which favors the utilization of a surgical team is that removal of an AN often requires prolonged delicate microsurgical dissection. The availability of two surgeons helps to avoid fatigue which can lead the operator to become impatient and less facile, neither of which are conducive to optimal functional outcome.