目的 介绍78例鞍上颅咽管瘤经翼点入路手术治疗的体会。方法 采用翼点入路开颅,应用显微手术解剖鞍区各脑池,充分利用鞍区4个解剖间隙切除肿瘤。结果肿瘤全切除72例,占92.3％;手术死亡2例,死亡率2.6％。术后随访1月-22年,平均3.6年。能正常日常工作或生活者67例,生活需要照顾者6例,死亡3例。结论 经翼点入路应用显微外科技术是提高鞍上颅咽管瘤手术全切除率,降低死亡率和复发率的重要手段。 Objective To introduce the experience of 78 cases of cranial craniopharyngiomas treated by pterional approach. Methods The pterional approach was used to craniotomy. Microsurgery was used to dissect the cerebral pools in the saddle area and make full use of the four anatomical spaces in the sellar area to remove the tumor. Results Tumor resection in 72 cases, accounting for 92.3%; surgical death in 2 cases, the mortality rate of 2.6%. Follow-up from January to 22 years, an average of 3.6 years. 67 cases of normal daily work or life, 6 cases of need of care in life, 3 cases of death. Conclusion The application of microsurgical technique via pterional approach is an important means to improve the total resection rate and reduce the mortality and recurrence rate of craniopharyngioma in the suprasellar region.