Foramen of Huschke is an anatomic variation of the tympanic portion of the temporal bone. There is little consensus on treatment of foramen of Huschke in symptomatic cases. Thus we present a surgical repairment case of foramen of Huschke. A 46-year-old man visited out-patient clinic due to severe otalgia accompanying mastication. And temporal bone CT revealed a 5 mm sized bony defect on anterior left EAC wall and herniation of soft tissue of the TMJ. We planned surgical repairment of the bony defect. Under general anesthesia, we try to repair by titanium mesh. Our first this attempt ended in failure due to incomplete covering of bony defect. We planned revision operation after 7 months, the bigger size titanium mesh inserted and anchoring that with surrounding soft tissue. Postoperative temporal bone CT revealed well situated titanium mesh covering TMJ with some calcified granulation tissue. Most cases of Foramen of Huschke are asymptomatic, but symptomatic case can be indication of surgical treatment by repairing EAC bony defect. And sufficient covering of bony defect and bearing capacity until stabilization of surrounding soft tissue are important in this procedure.