{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:31:49Z","timestamp":1747150309191,"version":"3.40.5"},"reference-count":56,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T00:00:00Z","timestamp":1681948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Exclusive endoscopic (EETTA) and expanded (ExpTTA) transcanal transpromontorial approaches have shown promising results for treating internal auditory canal (IAC) lesions. We reviewed the literature to answer the question: \u201cDo EETTA and ExpTTA achieve high rates of complete resection and low rates of complications in treating patients with IAC pathologies?\u201d<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources<\/jats:title><jats:p>PubMed, EMBASE, Scopus, Web of Science, and Cochrane were searched.<\/jats:p><\/jats:sec><jats:sec><jats:title>Review Methods<\/jats:title><jats:p>Studies reporting EETTA\/ExpTTA for IAC pathologies were included. Indications and techniques were discussed and meta\u2010analyzed rates of outcomes and complications were obtained with random\u2010effect model meta\u2010analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 16 studies comprising 173 patients, all with non\u2010serviceable hearing. Baseline FN function was mostly House\u2010Brackmann\u2010I (96.5%; 95% CI: 94.9\u201398.1%). Most lesions were vestibular\/cochlear schwannomas (98.3%; 95% CI: 96.7\u201399.8%) of Koos\u2010I (45.9%; 95% CI: 41.3\u201350.3%) or II (47.1%; 95% CI: 43\u201351.1%). EETTA was performed in 101 patients (58.4%; 95% CI: 52.4\u201364.3%) and ExpTTA in 72 (41.6%; 95% CI: 35.6\u201347.6%), achieving gross\u2010total resection in all cases. Transient complications occurred in 30 patients (17.3%; 95% CI: 13.9\u201320.5%), with meta\u2010analyzed rates of 9% (95% CI: 4\u201315%), comprising FN palsy with spontaneous resolution (10.4%; 95% CI: 7.7\u201313.1%). Persistent complications occurred in 34 patients (19.6%; 95% CI: 17.1\u201322.2%), with meta\u2010analyzed rates of 12% (95% CI: 7\u201319%), comprising persistent FN palsy in 22 patients (12.7%; 95% CI: 10.2\u201315.2%). Mean follow\u2010up was 16\u2009months (range, 1\u201369; 95% CI: 14.7\u201317.4). Post\u2010surgery FN function was stable in 131 patients (75.8%; 95% CI: 72.1\u201379.5%), worsened in 38 (21.9%; 95% CI: 18.8\u201325%), and improved in 4 (2.3%; 95% CI: 0.7\u20133.9%), with meta\u2010analyzed rates of improved\/stable response of 84% (95% CI: 76\u201390%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Transpromontorial approaches offer newer routes for IAC surgery, but their restricted indications and unfavorable FN outcomes currently limit their use. <jats:italic>Laryngoscope<\/jats:italic>, 133:2856\u20132867, 2023<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30703","type":"journal-article","created":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T17:11:33Z","timestamp":1682010693000},"page":"2856-2867","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Transcanal Transpromontorial Approaches to the Internal Auditory Canal: A Systematic 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