IN 1954 Parsons and Lewis introduced subtotal en bloc resection of the temporal bone for epidermoid carcinoma.1,2This formidable procedure causes facial paralysis and risks severe hemorrhage from internal carotid artery or jugular vein, yet is not always adequate for complete tumor removal. If a carcinoma extends into the anterior middle ear or invades the promontory, it will remain attached to the unresected petrous bone if this, now standard, procedure is performed. As the authors described in their original and subsequent papers, the temporal bone was separated from dura through mid- and posterior fossas craniotomy exposure and then chiseled across the petrous bone lateral to the internal auditory canal.2-4This cut extends through an anatomically weak zone across the petrous bone that is frequently followed by fractures. Transverse fractures commonly go through the carotid and jugular foramina lateral to the porus acusticus, through the bony labyrinth and medial