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目的：探讨采用经过改良Ｍｉｃｋｅｙ氏额颞－颞下窝入路结合面前径路（鼻侧切开或唇－上颌窦入路）切除中颅凹底大型内外沟通性瘤。方法：回顾分析我们１９９２年１月至１９９８年６月手术治疗的１６例患者。结果：成功切除了鼻咽癌６例，上颌窦腺鳞癌４例，脑膜瘤２例，血管纤维瘤２例，软骨肉瘤１例，尤文氏瘤１例。其中全切除６例，次全切除８例，大部切除２例。结论：１、该手术入路对向前、内侧侵及上颌窦、翼腭窝、筛窦及蝶窦的大型中颅凹底内外沟通瘤暴露充分，肿瘤得以广泛切除。２、采用改良的Ｍｉｃｋｅｙ氏额颞－颞下窝入路，复位后的额颞骨瓣由于来自颞肌血运保留，有利于骨瓣的成活及与正常颅骨的融合。同时颞肌在额颞骨附着点的保留，有利于术后患者咀嚼功能。
Objective: To explore the use of modified Mickey’s frontotemporal-infratemporal fossa approach combined with the anterior approach (nasal or maxillary sinus approach) for the removal of large internal and external tumors of the medial fossa. Methods: A retrospective analysis of our January 1992 to June 1998 surgery in 16 patients. Results: Six cases of nasopharyngeal carcinoma, four cases of maxillary sinus adenocarcinoma, two cases of meningioma, two cases of vascular fibroma, one case of chondrosarcoma and one case of Ewing’s disease were successfully resected. Total resection in 6 cases, subtotal resection in 8 cases, mostly in 2 cases. Conclusion: 1, The surgical approach to the anterior, medial invasion of the maxillary sinus, pterygopalatine fossa, ethmoid sinus and large medial fossa concave deep inside and outside the communication tumor is fully exposed, the tumor was extensive excision. 2, using modified Mickey’s frontotemporal-infratemporal fossa approach, after resection of the frontotemporal flap due to the reservation from the temporal muscle blood vessels, is conducive to the survival of the flap and the fusion with the normal skull. At the same time temporalis muscle in the frontotemporal bone attachment point of retention, is conducive to postoperative patients with chewing function.