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Objective: This article aimed to describe a new technique for the reconstruction of middle fossa tegmental defects using autologous osteocyte containing bone pate.

Study Design: The technique is demonstrated using clinical photographs and x-ray examples of tegmental defects.

Technique: Pliable bone pate graft is manufactured using autologous bone dust, blood, iodine solution, and tissue glue (Tisseel; Immuno, Austria). The graft is placed accurately via a combined mini-middle fossa craniotomy and middle mastoidectomy approach.

Conclusion: This new technique of middle fossa bony tegmental repair has considerable advantages over previously described methods that use rigid or synthetic materials.