Hi Cathie and welcome to this forum of new caring and supportive friends, who have been through what you are going through now.
My AN was only slightly larger than yours upon diagnosis, but for many reasons, I was not a good candidate for radiation treatment. My first surgery was via retrosigmoid approach because my hearing was considered salvageable. I chose my neurosurgeon very carefully for that surgery. Immediately post-op I was waaaaaay off balance and had double vision for a couple of weeks, but no headaches. I retained 20% of good, serviceable hearing, boosted with a normal hearing aid.
Fast forward to three years later, when it was determined my tumor had regrown to nearly the size of yours. This time I decided to go to House Ear Clinic in Los Angeles, who, in my view, has the most experience treating acoustic neuromas, where it was removed a second time via translabyrinthine approach. Post-op I had no new balance issues, no double vision and no headaches, but I was automatically totally deaf in my AN side ear. I knew I would be deaf before surgery so my bone-anchored hearing aid abutment was implanted at the same time. I love my Oticon Medical Ponto Pro hearing device!
Backing up again ..... my doctors at House feel very strongly that the radiation treatments to my head I had as a young girl had knocked out my vestibular nerve on my non-AN ear side, but I never connected that it was non-functioning (because my remaining vestibular nerve had taken over) until my AN formed on the only functioning nerve. That's why I was so impaired following my first AN surgery. I spent months in outpatient vestibular rehab and learned how to compensate for the missing vestibular nerve function. I am currently taking yoga classes each week, which helps tremendously to continue making the adjustments I will always have to make.
Please keep in mind, it is still considered rare for a surgically removed tumor to regrow. No doctor can guarantee hearing preservation with any surgery. There are too many variables that cannot be seen until a surgeon gets into the area. As for surgical complications, they too, are very rare, if you have an extremely competent neurosurgeon.
My advice to you is to search for the physician(s) with the most successful experience treating specifically acoustic neuromas, not just brain tumors in general.
At some point in your research, you will know what is best for you. After making your decision you will feel much better.
Thoughts and prayers. Clarice