The Cavitron ultrasonic surgical aspirator (CUSA) was used in a patient with an acoustic nerve tumour. After surgery she presented unilateral palsies of several cranial nerves. The nerve injuries were most likely induced by ultrasonic energy transmitted from the CUSA via the petrous bone. We suggest that when the CUSA is used in such operations care should be taken to avoid contact between the vibrating probe of the CUSA and the petrous bone.