We report a case of monostotic fibrous dysplasia of temporal bone in a 15-year-old male which presented with mass in the temporomastoid region. There was no associated complaint and patient came only for cosmetic correction of the asymmetry of skull. Conductive hearing loss was an incidental finding on audiogram. Computed tomography showed increased bone thickness with ground glass appearance. Shaded surface display of the skull was used in assessing the external bony deformity. Patient was operated for contouring of the bone and canalplasty which improved the cosmetic appearance as well as corrected the hearing loss thereby avoiding an extensive surgery. Patient is under regular follow-up with good cosmetic and functional results. This case highlights the importance of conservative surgery and regular follow-up in selective cases of temporal bone fibrous dysplasia along with use of shaded surface display for planning the correction of external deformity.
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