Hearing loss is very common in daily life, topping the list of all types of disabilities, with about 27.8 million in China, and is an important factor affecting people’s health and quality of life. Hearing and speech communication is an important means for people to understand the world, how is sound perceived by humans? Sound is transmitted from the outside world through the external auditory canal, the eardrum, the three auditory bones in the middle ear, the auditory cells in the inner ear, the auditory nerve, and the auditory center of the brain to form the auditory pathway. Depending on the degree of hearing impairment, it can be classified as mild, moderate, moderately severe, severe and profound deafness. Hearing loss is usually classified as conductive deafness, sensorineural deafness, or mixed deafness. Conductive deafness is caused by abnormalities of the outer ear and middle ear sound transmission structures, such as narrowing or atresia of the outer ear canal, tympanic membrane perforation, otitis media, middle ear cholesteatoma, abnormal auditory chain, etc. Sensorineural deafness is caused by lesions of the inner ear, auditory nerve and the center, with common causes such as hereditary deafness, congenital deafness, senile deafness, noise deafness, ototoxic deafness, sudden deafness, and auditory nerve and center lesions. The treatment of deafness mainly includes medication, hearing aids, and surgery. Mild deafness has less impact on the patient’s life, and this article focuses on several traditional and latest hearing reconstruction surgeries. Hearing reconstruction surgery is the surgical reconstruction of hearing loss caused by various causes. Traditional surgery is mainly for conductive deafness and mixed deafness, such as external canalplasty, tympanic membrane repair, auditory chain reconstruction, inner ear opening, etc. Different surgical procedures are used for different causes. For congenital or traumatic external atresia and external ear canal swelling, external otolaryngoplasty and external ear canal swelling removal are feasible to open up the external ear canal so that sound can be transmitted from the outside to the eardrum, and then hearing can be improved. For tympanic membrane perforation caused by trauma or otitis media, tympanic membrane repair surgery is feasible. For patients with middle ear deformity, secretory otitis media, chronic suppurative otitis media, middle ear cholesteatoma, otosclerosis and other middle ear lesions, the scope of the lesion should be clearly investigated during surgery. Depending on the condition, a second operation can be performed. For patients with interrupted or fixed auditory chain, an appropriate artificial bone can be used, which is equivalent to bridging the sound conduction pathway, so that sound can be transmitted from the outer ear to the inner ear through the bridge, thus improving hearing. In patients with otosclerosis, after stapedectomy, the stapes floor is opened and a special artificial bone is implanted, usually resulting in good hearing reconstruction. The material used to build the bridge can be autologous bone or various artificial materials, such as polyethylene, Teflon, bioceramics and alloys, etc. Due to the foreign body rejection of the human body, the titanium alloy artificial hearing bone commonly used in clinical practice is very effective, easy to plasticity, light quality, small rejection reaction, good results, and some cases can be close to the normal hearing level after surgery. Armed police general hospital in recent years to carry out a phase of mastoid opening + artificial hearing bone rehearing construction + tympanic membrane repair, achieved very good treatment results, and shorten the hospitalization time, save the patient’s hospitalization costs, by the praise. However, the traditional surgical methods in clinical work cannot solve the hearing problems of all deaf patients, such as re-occlusion after external atresia, patients with otitis media combined with different degrees of sensorineural deafness, severe and very severe sensorineural deafness, auditory nerve pathway lesions, etc. These need new high-tech means to carry out artificial auditory implantation. There are several new surgical options available clinically to improve hearing, such as cochlear implantation, vibrating acoustic bridges, bone anchored hearing aid implantation, combined electroacoustic stimulation, and midbrain and brainstem implants. Cochlear implantation can replace the function of damaged hair cells in the inner ear, convert sound into electrical signals and transmit them to the brain via auditory nerve fibers to produce hearing. It can help patients with severe and very severe sensorineural deafness to gain or restore hearing, and is currently the only method recognized by the international medical community to restore hearing to patients with severe sensorineural deafness, enabling them to move from a world of no sound to a world of sound. Cochlear implant surgery requires a full set of work procedures including preoperative evaluation, preoperative training, surgery, postoperative debugging and hearing and speech rehabilitation by a team of professionals working together with the patient and family. Cochlear implants can help patients of all ages (>1 year old) with severe deafness in both ears, and pediatric patients should receive the surgery as early as possible so as not to miss the golden period of language learning for better rehabilitation results. Cochlear implants have been used abroad for more than 30 years and in China for about 20 years. The technology is mature and the products are stable and are designed for lifetime use. Post-operative speech rehabilitation for prelingually deaf children is relatively long, requiring months or even years of speech rehabilitation before they can enter normal school and be able to sing and communicate verbally. Post-speech deaf adults, on the other hand, are able to communicate in simple speech after a few weeks of post-surgical speech rehabilitation, even on the same day they are turned on. Of course there should be reasonable expectations for cochlear implants, and in a few cases the post-operative results are not as good as they could be. Factors that can affect the outcome of cochlear implants include the length of deafness, age at the time of deafness, age at the time of surgical implantation, cause of deafness, condition of the auditory nerve fibers in the inner ear, and speech rehabilitation training. Vibroacoustic bridge technology is considered the most successful middle ear implantable hearing aid and has been widely used in Europe and the United States, and was introduced into China in 2010 and started to be used in clinical applications. The external sound signal is captured, processed and encoded by the external processor of the vibro-acoustic bridge, and transmitted as radio waves through the scalp to the implant in the body, where the signal is transmitted to a floating mass sensor, which is eventually converted into mechanical vibrations and transmitted to the inner ear. If the transducer is fixed to the auditory chain, it directly drives the middle ear structure, generating and amplifying the vibration of the auditory chain to improve the hearing of patients with sensorineural deafness; if the transducer is fixed to the round window membrane and directly vibrates the inner ear lymph fluid, transmitting and amplifying the inner ear vibration, which is the unique direct drive technology of the vibroacoustic bridge. By bypassing the outer and middle ears and driving the inner ear directly, the Vibroacoustic Bridge replaces the functions of the outer and middle ears and is also known as the “artificial middle ear”. With its dual function of sound transmission and amplification, the vibrating bridge is an excellent alternative for conductive and mixed deafness that cannot be addressed by traditional surgery. Bone anchored hearing aid is an implantable hearing aid that improves hearing through bone conduction. Bone anchored hearing aids have superior performance and are simple to implant, and are widely used in China and abroad. The microphone of the sound processor receives the sound from the outside world, and after an electromagnetic conversion device, the sound energy is converted into mechanical vibrations and causes efficient vibrations of the titanium screws in the skull, which are transmitted through the skull vibrations to the inner ear causing fluctuations of the endolymphatic fluid and thus stimulating the sensory hair cells. Bone anchored hearing aid implantation is suitable for those patients with bilateral conductive or sensorineural deafness who are not suitable for traditional hearing reconstruction surgery and those who do not have satisfactory results with traditional bone conduction hearing aids, such as congenital external atresia, bilateral otitis media, bilateral otosclerosis, etc.; patients with unilateral conductive deafness, mixed deafness, and sensorineural deafness, so that they can obtain stereo hearing in both ears. The application of minimally invasive techniques in cochlear implantation, preservation of the function of residual hair cells in the cochlea, and combined acoustic and electrical stimulation implantation techniques have greatly improved the postoperative results, and the implantation of auditory devices in the auditory center of the brain, such as midbrain implantation and brainstem implantation techniques, are also in their initial stages abroad. In conclusion, the current artificial auditory implantation techniques cannot solve all hearing problems, and the technologies that have been developed will encounter new challenges in the process of clinical application.