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A retrospective analysis of 109 consecutive patients presenting with acoustic neuromas between 1986 and 1997 were undertaken. Sufficient data were available in 104 cases for comparison. In 65 cases patients had undergone surgery and the radiological diagnosis of acoustic neuroma was confirmed histologically. In this group there were 25 large and 40 small tumors when a maximal radiological diameter of 2.5 cm was used to subdivide the groups. When pure tone thresholds were compared at specific frequencies, in those with hearing ears, there was no significant difference between the two groups. Our results are compared with recent series and the causes of hearing loss associated with acoustic neuroma are discussed.