We describe a surgical technique in which the middle fossa craniotomy
ordinarily used for facial nerve decompression and related surgery is
extended superiorly to allow the harvest of a split-thickness calvaria
l graft. This graft allows the tegmen defect in middle fossa surgery t
o be repaired without shortening the original craniotomy plate. Avoidi
ng the usual temporoparietal depression after middle cranial fossa sur
gery is both a structural and cosmetic benefit for the patient.