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（目的〕介绍扩大额下前颅窝底入路的手术方法，并报告10例中线部位累及广泛的巨大颅底沟通瘤显微手术体会。（方法）采用额部开颅同时行眉弓-眶顶成形，蝶骨平台及眶顶磨除，经硬股外、硬膜下联合入路在显微镜下一次切除肿瘤，最后行颅底重建。（结果）10例中肿瘤全切5例，近全切3例，大部切除2例。病理报告良性肿瘤7例，恶性肿瘤3例。无手术死亡及严重并发症；术后视力恢复正常，鼻塞流涕及吞咽呛咳等临床症状均有明显改善。术后均恢复正常生活。（结论）该入路适用于颅底中线部位累及广泛的肿瘤；具有暴露充分，脑组织损伤小，切除较彻底及术后并发症少等优点。颅底重建是手术成功的关键之一。
(Department of Otorhinolaryngology Head and Neck Surgery, Department of Otorhinolaryngology Head and Neck Surgery, Department of Otorhinolaryngology Head and Neck Surgery, Top forming, sphenoid platform and orbital roof ablation, the hard extradiscal, subdural combined approach to remove the tumor under a microscope, and finally skull base reconstruction (results) 10 cases of tumor resection in 5 cases, nearly all 3 cases were resected, and 2 cases were mostly resected.Pathological reports of 7 cases of benign tumors, 3 cases of malignant tumors.No operative mortality and serious complications; visual acuity returned to normal, nasal congestion and nasal discharge and cough and other clinical symptoms were significantly improved .Conclusion: This approach is suitable for the extensive tumor in the midline of the skull base with the advantages of adequate exposure, less damage of brain tissue, thorough resection and less postoperative complications, etc. Skull base reconstruction One of the keys to successful surgery.