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In the cerebellopontine angle (CPA), it has shown few advantages over microscopic surgery alone, evolving towards a full-endoscopic surgery for neurovascular conflicts and tumors. This review aims to systematically analyze the literature about the use of the endoscope in the cerebellopontine angle tumors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Pubmed\/Medline and Embase databases were investigated applying PRISMA guidelines without time restrictions to find all adult patients affected by an extra-axial cerebellopontine angle tumor (vestibular schwannoma, meningioma, epidermoid tumor, or other extra-axial lesions) treated using only the endoscope (full-endoscopic, FE or endoscopic-controlled, EC) or with endoscopic assistance (EA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After article selection, a total of 2489 patients have been treated for a CPA lesion using the endoscope: 2054 vestibular schwannomas (VS), 368 epidermoid tumors (ET), 41 meningiomas and 26 among other pathologies. The retrosigmoid approach was the most frequently employed surgical corridor, irrespective of lesion type, for both full-endoscopic and endoscopic-assisted procedures. Although a great heterogeneity should be highlighted among the selected series of VS (1539), a weighted average of 92.5% of gross total resection (GTR) was obtained and 90% out of 1332 showed a good facial nerve outcome when comparable. Advantages in term of recognition of residuals have been described for the CPA meningiomas and multicompartmental epidermoid tumors with origin from CPA cistern, without increasing the risk of complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite different accepted advantages, the number of tumors in which the endoscope has been included among the surgical armamentarium is still limited compared to the number of the full-microscopic resections. After almost 30 years since its value was recognized, the number of prospective and case-control studies is still scarce to affirm a real benefit leading to its routinary use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00405-025-09427-4","type":"journal-article","created":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T03:05:29Z","timestamp":1746068729000},"page":"5445-5460","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A systematic review on the role of the endoscope in the surgical management of cerebellopontine angle tumors: is it time to draw the conclusion?"],"prefix":"10.1007","volume":"282","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5187-4689","authenticated-orcid":false,"given":"Raffaele","family":"De Marco","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S\u00e9bastien","family":"Froelich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Albera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diego","family":"Garbossa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Zenga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,4,30]]},"reference":[{"key":"9427_CR1","unstructured":"O\u2019Donoghue G, O\u2019flynn P (1993) Endoscopic anatomy of the cerebellopontine angle. 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This article does not contain any studies with animals performed by any of the authors. We confirm that the manuscript has been read and approved by all named authors and that there are no other persons who satisfied the criteria for authorship but are not listed. We further confirm that the order of authors listed in the manuscript has been approved by all of us. We confirm that we have given due consideration to the protection of intellectual property associated with this work and that there are no impediments to publication, including the timing of publication, with respect to intellectual property. In so doing we confirm that we have followed the regulations of our institutions concerning intellectual property. We further confirm that any aspect of the work covered in this manuscript that has involved either experimental animals or human patients has been conducted with the ethical approval of all relevant bodies and that such approvals are acknowledged within the manuscript. We understand that the Corresponding Author is the sole contact for the Editorial process (including Editorial Manager and direct communications with the office). He\/she is responsible for communicating with the other authors about progress, submissions of revisions and final approval of proofs. We confirm that we have provided a current, correct email address which is accessible by the Corresponding Author and which has been configured to accept email from.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}