A 47-year-old woman with left temporal bone herniation had a history of treatment of chronic cholesteatomatous otitis media. After clinical and radiological diagnosis, the defect was repaired using a middle fossa craniotomy approach and a Vicryl-collagen(R) plate. There were no postoperative surgical complications and the repair was successful. The sequellae of herniation of the temporal lobe and dura are potentially lethal and difficult to correct surgically.