Learning Objectives: The preoperative hearing status is one of the important factors to determine the method of surgical approach to the vestibular schwannoma. It has been widely recognized that the hearing preservation surgery is not valuable if the patient has no serviceable hearing. The worldwide reported cases of hearing improvement after surgical removal of vestibular schwannoma with profound hearing disturbance are extremely rare so far. The authors have experienced a significant hearing improvement after surgical removal of vestibular schwannoma with preoperative unilateral total deafness but normal otoacoustic emission response, therefore we should consult the OAE response when diciding the approach method of vestibular schwannoma surgery.