Congenital microtia is the most common facial deformity after cleft lip and cleft palate, and it is also the most common congenital deformity that leads to facial asymmetry, and its incidence rate reaches 1.4 per 10,000 in our country. congenital microtia seriously affects the patient’s appearance and mental health, and outer ear reconstruction is the better treatment method at present. The 4 most common questions about congenital microtia: 1. What materials are used for ear reconstruction? Is it safe? The material used for ear reconstruction mainly consists of two parts: the auricular scaffold and the skin covering the scaffold. There is no doubt that only the patient’s own skin can be used. There are two main types of auricular scaffolds used for ear reconstruction: autologous rib cartilage sculpted scaffolds and Medpor artificial material scaffolds. Since the artificial materials have the disadvantages of being easily exposed and difficult to deal with after exposure (especially in children), it is generally accepted that autologous rib cartilage scaffolds are preferred for reconstructing the ear, especially in children, and that artificial materials should only be considered in older people when the autologous rib cartilage may not work well. Is it safe to use a child’s own rib cartilage? Does it affect the child’s development? Since only 2 to 3 ribs are needed, the trauma caused by the removal of the rib cartilage is limited, and generally speaking, the impact on the child’s growth and development is very small, and there is no problem at all in carrying out normal study, life, and work after the surgery. To make an analogy, if a house is being renovated and a few bricks are removed from the wall, the stability of the wall will be almost unaffected. 2.When is the most suitable time for ear reconstruction surgery? For a very small number of congenital microtia where most of the auricular structure exists but the contracture pull is more obvious, it is recommended that local corrective surgery can be done at the age of 1~3 years old, which will not only make the microtia form more beautiful, but also eliminate the growth and development abnormality of the auricle due to the contracture. However, for most congenital microtia, ear reconstruction surgery is needed because most of the auricular structures are missing, and the optimal age for ear reconstruction surgery is around 6 to 14 years old. Because firstly, the growth of the auricle has its own characteristics, at the age of 6, the size of the auricle has already reached 85% of the adult size, and almost stops growing after the age of 10, therefore, after the age of 6, it is completely possible to refer to the size and shape of the healthy side of the auricle for ear reconstruction. Secondly, children’s ear reconstruction using autologous rib cartilage, need to children’s height of 120cm or more to have enough rib cartilage for ear stent carving, generally children around 6 years old have 120cm height, age is too small, height is less than 120cm, rib cartilage is not enough, in addition to the age of 14 within the rib cartilage’s elasticity is particularly good, easy to ear stenting, after that, the older the age of the rib cartilage elasticity gradually decline or calcification, which is not conducive to the ear stenting. After that, the age of the rib cartilage gradually decreases the elasticity of the rib cartilage or calcification, which is not favorable for the formation of the ear support. Therefore, the optimal age for surgery is around 6 to 14 years old. Of course, it is not absolute, we have done a lot of surgeries and found that the elasticity of rib cartilage of young people in their 20s is still very good. 3.Do I need to rebuild my hearing during ear reconstruction? Generally, congenital microtia is characterized by normal development of the inner ear on the affected side, but atresia of the temporal bone, absence of external auditory canal, abnormal development of the auditory ossicles and poor development of the auditory ossicular chain, which results in poor hearing in the affected ear. Reconstruction of hearing means making a hole in the temporal bone to rebuild the external auditory canal and middle ear. Due to the poor development of the auditory ossicles, hearing reconstruction surgery can only improve hearing, but not completely restore normal hearing, and in addition to the risk of surgical damage itself, it is prone to wet ear, smelly ear and other very troublesome complications. Since the healthy ear of unilateral congenital microtia has good hearing and will not affect daily life and work due to hearing problems, it is recommended that unilateral microtia patients only need to undergo auricular reconstruction to improve their appearance. However, for those with bilateral microtia, hearing problems on both sides of the ear will not affect their daily life and work, and hearing reconstruction surgery is recommended. It is also recommended that auricular reconstruction surgery should come first, and hearing reconstruction surgery should come later, because auricular reconstruction surgery can reserve a good position for future hearing reconstruction surgery, and if hearing reconstruction surgery is carried out first, it will often lead to scarring of the skin behind the ear, which will affect the implementation of subsequent auricular reconstruction surgery. 4. What is the best surgical method? External ear reconstruction surgery covers skin flap, fascia flap, skin, cartilage transplantation, cartilage sculpture and dilator application and other plastic surgery techniques, is a systematic project, is one of the more complex plastic surgery. There are many different surgical methods, and the more mature and recognized methods include the four-stage surgical method proposed by Brent in the 1980s, the two-stage method proposed by Nagata in the early 1990s, the three-stage expander method proposed by Park at the end of the 1990s, and the distinctive Zhuang’s three-stage expander method applied by Prof. Zhuang Hongxing in China since the early 1990s. We use different surgical methods according to the specific situation, and the most applied are Zhuang’s three-phase expander method and our own original delayed posterior ear flap plus autologous rib cartilage stereoscopic scaffolding method of external ear reconstruction (Hunan Science and Technology Program Project, No. 2012SK3238, the paper has been published in the Chinese Journal of Aesthetics and Aesthetics of Medicine, Issue 4, 2014, and other academic journals), not only to make reconstructed ear is exquisite and realistic, but also let the patient take the risk of Not only does it make the reconstructed ear look like a real one, but it also allows the patient to bear little risk, low pain, fast recovery and short hospitalization time, and it has treated a large number of cases, all of which have achieved excellent results. Roughly speaking, the surgery is carried out in two to three stages. The first stage of the surgery is relatively simple, it is to prepare for the second stage of the surgery, like a dilator, the purpose is to provide a thin, large enough flap for the reconstruction of the ear, the blood flow to ensure that the flap. This is commonly referred to as “laying the foundation”. The second stage of surgery is performed about 3 weeks after surgery. The second stage of the surgery is the external ear reconstruction surgery, which is the key surgery, after the surgery, the three-dimensional shape of the auricle structure is completely available, and the second stage of the surgery is commonly referred to as “building a house”. After half a year of surgery, the third stage of surgery will be performed depending on the situation, and some people may not undergo the third stage of surgery. Phase III surgery includes ear screen reconstruction, external auditory canal molding and partial repair of the reconstructed ear, which is commonly referred to as “renovation”.