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目的：提高内侧型蝶骨嵴脑膜瘤的全切率，降低死亡率和致残率。方法：回顾性分析一组２０例病例的显微外科治疗。结果：多数表现为单眼视力下降。冠状位ＣＴ有助于判断肿瘤的生长点。ＭＲＩ可显示肿瘤与海绵窦、颈内动脉的关系。１例肿瘤侵入海绵窦，１１例肿瘤包绕颈内动脉和主要分支。肿瘤附着点为前床突和（或）小翼的内侧。１５例达ＳｉｍｐｓｏｎⅠ、Ⅱ级全切除。术后偏瘫２例，无死亡。结论：手术要点是尽早离断肿瘤基底并沿颈内动脉床突上段由近向远分离切除包绕的肿瘤。由于多数存在肿瘤与血管之间的蛛网膜界面，作者提倡在第一次手术中采用积极的显微外科治疗
Objective: To improve the total excision rate of medial sphenoid ridge meningioma and reduce mortality and disability. Methods: Retrospective analysis of a group of 20 cases of microsurgical treatment. Results: Most of the performance was monocular visual acuity. Coronal CT can help determine the growth point of the tumor. MRI can show the relationship between tumor and cavernous sinus, internal carotid artery. One case of tumor invaded the cavernous sinus, and 11 cases surrounded the internal carotid artery and main branches. The tumor attachment site is the medial side of the anterior cot and/or winglet. 15 patients had Simpson I and II total resection. Hemiplegia occurred in 2 cases and no death occurred. Conclusions: The main point of operation is to cut off the tumor base as soon as possible and cut the surrounding tumor from the proximal to distal part along the upper segment of the internal carotid artery. Since most of the arachnoid interfaces between tumors and blood vessels exist, the authors advocate aggressive microsurgical treatment during the first operation.