The rationale for laser use in tumor resection is both to allow for “no-touch” cutting and for tissue debulking, with hemostatic benefit. Laser surgery, in general, has shown various advantages, such as reduction of mechanical trauma and intraoperative bleeding. Three types of laser have been successfully used in vestibular schwannoma surgery, potassium titanyl phosphate (KTP-532), CO2, and the novel 2μ-thulium lasers, which has been deemed safe especially in “difficult” conditions (e.g., highly vascularized and hard tumors). The ultrasound aspirator (USA) is used for tissue fragmentation; modern devices are supposed to leave the neurovascular structures around the surgical site largely untouched. The use of the USA for meatal bone removal has recently been introduced in routine skull base surgery as an alternative to the neurotologic drill. Care must be taken in controlling suction, irrigation, and power settings to obtain ideal results and avoid any damage to surrounding dura and soft tissues; the senior authors of this book suggest the configuration Power:50, Suction:5, Irrigation:5 for debulking and increasing power settings for internal auditory canal unroofing.