目的 :探讨天幕脑膜瘤的分型和手术入路的选择。　方法 :对 1992年 1月至 2 0 0 2年 12月间收治的天幕脑膜瘤进行回顾性分析 ,并按分型选择不同的手术入路。本组 5 6例 ,其中内侧型 2 8例 ;外侧型 17例 ;镰幕型 11例。对主要向幕上发展者 ,根据肿瘤的部位 ,采用扩大翼点入路、颞下入路、颞枕部入路和枕部入路 ;肿瘤全部或主体在颅后窝者 ,采用枕下或枕部 枕下联合开颅术 ;跨幕者采用颞下 乙状窦前入路 ;镰幕型均采用枕部入路。　结果 :本组肿瘤全切除 5 3例 ,部分切除 3例 ,全组共死亡 2例 (3.6 % ) ,术后出现新增神经功能障碍 5例 ,复发 6例。　结论 :天幕脑膜瘤手术入路的选择必须根据患者的具体情况进行个体化设计 ;熟悉局部显微解剖并熟练运用显微外科技术是取得手术成功的关键 Objective: To explore the classification of the type of meningioma and the choice of surgical approach. Methods: A retrospective analysis was performed on ameloblastoma treated between January 1992 and December 2002, and different surgical approaches were selected according to the type. The group of 56 cases, of which 28 cases of medial type; lateral type in 17 cases; sickle screen in 11 cases. On the main screen to the developers, according to the site of the tumor, the use of expanded pterional approach, infratemporal approach, temporal occipital approach and occipital approach; all or main tumor in the posterior fossa of the skull, using suboccipital or Occipital suboccipital joint craniotomy; transvestite use of inferior temporal sigmoid anterior approach; sickle-screen type are used occipital approach. Results: Totally resected in this group of 53 cases of tumor, partial resection in 3 cases, the total group of 2 deaths (3.6%), 5 cases of postoperative neurological dysfunction, recurrence in 6 cases. CONCLUSIONS: The selection of the surgical approach to meningioma should be individualized based on the patient’s specific conditions. Being familiar with local microdissection and using microsurgical techniques is the key to successful surgery