When the traumatic fracture lines of temporal bone cross the geniculate fossa, labyrinthine segment of the facial nerve, and the internal auditory canal, we have to choose the middle-cranial fossa-approach-technique in order to manage the facial paralysis. This technique requires complete acknowledgement of the complex three-dimensional anatomy of the temporal bone and the cranial vault, but this procedure has to be performed in selective cases, because of limited advantages. Recently we performed this technique in the cases of the traumatic temporal bone fracture patients; 4 cases of the facial nerve decompression, 1 case of the end-to-end anastomosis. Finally we got satisfactory results. So, we report our experiences and the advantages of middle cranial fossa approach technique.