ABSTRACT
This report describes the removal of the roof of the external auditory meatus in approaching
the tentorial edge, the cerebropontine angle, hippocampal brainstem lesions, and upper
clival lesions. This procedure not only provides more space in approaching the tentorial
edge or upper brainstem, it also provides a wider entry space for approaching posterior
fossa lesions. This approach is also for lesions located lower than the tentorium
or in the upper clivus. There is still some confusion about the method for removing
the roof of the external auditory canal. We describe the clinical experience and comprehensive
surgical procedures used on cadavers. Our extended temporal craniotomy technique using
the removal of the roof of the external auditory meatus is a simple, safe, and useful
method for obtaining a wider entry space to approach deep perimesencephalic lesions
and the posterior fossa.
