ObjectiveTo analyze the clinical prognosis of Cystic acoustic neuroma (CVS) and Solid acoustic neuroma (SVS).MethodsA retrospective analysis of clinical data of 417 patients with acoustic neuroma from 2017 to 2020 was performed, including intraoperative resection and postoperative complications (such as tinnitus, dizziness, hearing loss, balance disorders, headache, and facial nerve dysfunction).ResultsThe average tumor size in the CVS group (2.94 ± 0.87 cm) was larger than that in the SVS group (2.12 ± 0.87 cm). Total resection was achieved in 271/286 cases (94.8%) of the SVS group, and partial resection in 15/286 cases (5.2%). In the CVS group, total resection was achieved in 104/131 cases (79.4%) and partial resection in 27/131 cases (20.6%), with a statistically significant difference between the two groups (P < 0.001). Postoperative complications inclding tinnitus (P = 0.020), dizziness (P = 0.037), hearing loss (P = 0.038), and headache (P = 0.019) all showed statistical differences between the SVS and CVS groups, while postoperative balance disorders (P = 0.959) and facial nerve injury (P = 0.092) did not show statistical differences between the two groups.ConclusionCVS has a worse clinical prognosis than SVS, but there is no significant difference in facial nerve function damage between the two groups, and tumor size is not related to facial nerve function damage.