目的　探讨大型前庭神经雪旺细胞瘤与面神经的解剖关系。方法　采用枕下乙状窦后入路 ,术中直接观察了 40例肿瘤直径大于 4cm以上的前庭神经雪旺细胞瘤的面神经与肿瘤解剖关系。结果　面神经解剖位置 :(1)腹侧方中部 :2 3(5 8% ) ;(2 )背侧方 :1例 (2 % ) ;(3)腹侧方上极 :4例(10 % ) ;(4 )腹侧方下极 :8例 (2 0 % ) ;(5 )术中面神经迷行 4例 (10 % )。面神经形态 :扁片状 31例 ,圆隆状 9例。扁片状的面神经以实质性前庭神经雪旺细胞瘤为主 ,圆隆状的面神经以囊性前庭神经雪旺细胞瘤为主。结论　面神经与前庭神经雪旺细胞瘤的解剖变异较大 ,加强术中监测可提高手术安全性 Objective To investigate the anatomic relationship between large-sized vestibular schwann cell tumor and facial nerve. Methods The suboccipital sigmoid sinus posterior approach was used to directly observe the relationship between the facial nerve and the tumor in 40 cases of tumors of the Schwannoma cell of the vestibular tumors larger than 4 cm in diameter. (2) dorsal side: 1 case (2%); (3) ventral side of the pole: 4 cases (10%); ; (4) the ventral side pole: 8 cases (20%); (5) intraoperative facial nerve delusion in 4 cases (10%). Facial nerve morphology: flat sheet in 31 cases, 9 cases of round shape. Flat-sided facial nerve to the main vestibular Schwannoma tumor-based, rounded facial nerve cystic vestibular Schwannoblastoma dominated. Conclusion The facial nerve and vestibular Schwannoma have large anatomical variations, and enhancing intraoperative monitoring can improve the safety of surgery