目的：介绍并讨论一种处理斜坡及斜坡旁区肿瘤及血管病变经岩骨手术入路。方法：对２８例病人实施了乙状窦前－迷路后经岩骨幕上下联合入路手术。结果：显微镜下肿瘤全切率８２％，３例桥脑内海绵状血管瘤全部切除，３例基底动脉瘤均成功夹闭。术后４例出现暂时性颅神经损伤症状，１例出现永久性动眼神经损伤症状。颅神经损伤发生率为１８％。２例术后脑脊液漏，２例术后死亡，其余病人恢复良好并均保留了听力。结论：该手术入路的主要优点：对小脑及颞叶牵拉轻；可缩短到达斜坡的距离，并对斜坡区提供良好的暴露，可以保留耳蜗、面神经、横窦、乙状窦及Ｌａｂｂｅ静脉等重要结构 OBJECTIVE: To introduce and discuss a surgical approach to the treatment of tumors and vascular lesions in slopes and parasagittal regions. METHODS: Twenty-eight patients underwent anterior and posterior sigmoid sinus surgery followed by an intercondylar approach. Results: Under the microscope, the total tumor resection rate was 82%. All 3 cases of cavernous hemangioma in the pons were resected and 3 cases of basilar aneurysm were successfully clipped. Postoperative cranial nerve injury occurred in 4 patients, and permanent ocular nerve injury occurred in 1 patient. The incidence of cranial nerve injury was 18%. CSF leakage occurred in 2 cases and 2 cases died after operation. The rest of the patients recovered well and all of them retained hearing. Conclusions: The main advantages of this surgical approach are: lighter cerebellum and temporal lobe pull; shorter reach to the slope; and good exposure to the slope area to preserve the cochlea, facial nerve, transverse sinus, sigmoid sinus, and Labbe vein Important structures