In the clinic, we often encounter parents who ask, “Doctor, does your child have hearing?” In patients with microtia with external atresia, the middle ear hamate and anvil bones are often fused and underdeveloped, and the stapes is often deformed, resulting in significant air-conduction hearing impairment. The inner ear is also slightly malformed, but bone conduction hearing is generally unaffected. In layman’s terms, this means that the hearing on the affected side is worse. In cases of unilateral microtia with external atresia, the hearing is not affected because the patient has a normal ear to compensate for it, so auricular reconstruction can be performed first, and then middle ear surgery can be performed as needed. For patients with bilateral microtia with external atresia, surgery of the external ear canal and middle ear can improve hearing appropriately, so it is possible to choose whether to perform hearing function surgery first depending on the patient’s hearing function. It is also worth noting that simple hearing reconstruction surgery often destroys the local anatomy of the small ear side, which makes reconstruction of the auricle very difficult, so it is recommended that auricular reconstruction be performed before hearing reconstruction surgery!