I had the retrosigmoid approach to remove my large (4.5cm) AN in June, 2006. It proved very successful in my case (no headaches, CSF leaks or facial nerve problems) but of course, only your neurosurgeon (and you) can decide what surgical approach is best for you. The retrosigmoid approach does help preserve hearing, if your hearing is still viable pre-op, but hearing preservation cannot be guaranteed. Be aware that neurosurgeon's opinions will vary, based on their personal experience and biases for (or against) certain types of microsurgery. They are humans, not all-knowing gods, despite what a few may think. You have to educate yourself (as you are doing here) and take control of your medical decisions, based on accurate knowledge and information. This site is a storehouse of that kind of information. Please use it - and the best of luck to you.