目的探讨蝶骨嵴内侧大型脑膜瘤的显微外科治疗方法。方法回顾性分析28例蝶骨嵴内侧大型脑膜瘤显微外科手术。结果21例达SimpsonⅠ、Ⅱ级切除,7例达SimpsonⅢ级切除。术后偏瘫4例,植物生存2例,无死亡。结论改良的翼点入路适于切除蝶骨嵴内侧大型脑膜瘤,掌握处理侵犯视神经、颈内动脉及海绵窦的手术技巧是提高肿瘤全切率的关键,但是对于明显侵犯颈内动脉、海绵窦等重要结构的肿瘤尚应考虑姑息的手术方式。 Objective To investigate the microsurgical treatment of large meningioma in the sphenoid ridge. Methods A retrospective analysis of 28 cases of sphenoid ridge medial meningiomas microsurgery. Results 21 cases reached Simpson Ⅰ, Ⅱ level resection, 7 cases up to Simpson Ⅲ level resection. 4 cases of postoperative hemiplegia, plant survival in 2 cases, no death. Conclusion The modified pterional approach is suitable for the removal of large meningiomas in the medial sphenoid ridge. It is the key to improve the surgical rate of the tumor by masking the surgical techniques that infringe the optic nerve, internal carotid artery and cavernous sinus. However, Sinus and other important structures of the tumor should be considered palliative surgery.