目的　探讨巨型斜坡中线区脊索瘤的手术治疗方法。方法　采用经扩大额下硬膜外入路切除 13例巨型斜坡脊索瘤 (直径大于 4cm)。介绍入路方法、肿瘤切除程度和疗效随访 ,探讨肿瘤残留的原因和处理 ,并与其它入路比较适用范围。结果　本组巨型斜坡脊索瘤全切除 3例 ,次全或大部切除 7例 ,部分切除 3例 ,无手术死亡 ,无严重并发症。随访2～ 7年 ,3例肿瘤全切除者未见复发 ,其余 10例中 2例死亡 ,1例失访 ,3例病情稳定 ,另 4例因斜坡中线区以外肿瘤复发经其它入路再次手术 ,生存至今。结论　采用扩大额下硬膜外入路 ,切除主要沿颅底中线方向生长的巨型斜坡脊索瘤 ,疗效满意。对偏离中线方向生长的较大肿瘤 ,须采用联合入路手术。 Objective To investigate the surgical treatment of giant chordoma in the midline of the slope. Methods Thirteen giant chordomas (larger than 4 cm in diameter) were excised by an extended epidural approach. Introduce the approach, follow-up of the degree of tumor resection and curative effect, explore the reason and treatment of tumor residue, and compare with other approaches. Results In this group, 3 cases were treated with total removal of giant chordate chordoma, subtotal or partial resection in 7 cases, partial resection in 3 cases, no operative death and no serious complications. During 2 to 7 years of follow-up, no recurrence was found in 3 cases of total resection of the tumor, 2 of the remaining 10 cases died, 1 case was lost to follow-up, 3 cases were stable and the other 4 cases were reoperated by other approaches due to tumor recurrence outside the slope midline region , Survive so far. Conclusions The extended epicardial approach and the removal of giant chordoma that mainly grow along the midline of skull base are satisfactory. For large tumors that deviate from the midline direction, a combined approach is required.