You say that the little ear is a wound in your hearts; but I say that it is a disease, and that you need not blame yourselves too much. You expect an ear. Yes, we can personalize the treatment. You expect better hearing. I say, there are many ways to improve hearing, not just opening the ear canal. You ask, can we open the ear canal first; I say, it is best to consider plastic surgery first. You think, I don’t understand your considerations; well, do you understand my sadness. Ear Flap The flap behind the ear includes the skin, superficial fascia, temporal fascia, temporalis muscle, and cranial epicondyle. Among them, the superficial fascia contains the postauricular arteries and veins, and they provide blood supply during auricular reconstruction to ensure that the auricle is viable. Opening the ear canal first or any surgical approach to hearing reconstruction will disrupt the blood supply to the superficial fascia behind the ear, scarring and skin tension will increase, affecting the auricular reconstruction. Plastic surgery or reconstruction first? This is always a question that you consider and one that we would worry about. Therefore, to be clear, the overall principle is: plastic surgery before hearing reconstruction, or both at the same time. This also relies heavily on the abundance and diversity of hearing intervention programs now available, giving us room to develop a more superior program. Safety comes first and results go hand in hand. External ossiculoplasty-tubuloplasty, with the goal of improving hearing, is, as the word implies, the reconstruction of an external auditory canal and a tympanic chamber. Opening the ear canal, the auditory chain, the eardrum, and the external auditory canal In actual surgical practice, all three of these structures are essential if hearing is to be improved by “opening the ear canal”, and any one of these structures is at fault. Problems with any one of these structures, such as re-stenosis or atresia of the external auditory canal, thickening of the eardrum, or displacement of the auditory ossicles, can all lead to poor hearing results after surgery. It is important to be cautious about opening the ear canal to improve hearing, as the need for aesthetics of the ear canal is not as important as the need for safety. Hearing Options Microtia, hearing manifests as conductive deafness, audiogram shows: air conduction is poor, bone conduction is usually normal, everyone has two ways of hearing. Air conduction and bone conduction, but in the evolution of mankind, air conduction hearing is the main, bone conduction hearing is supplemented, when listening to others, usually air conduction hearing, Beethoven suffered from ear disease in order to create, he used a piece of wooden stick on the piano cover, the other end of the other end of the bite in the middle of the teeth is the bone conduction sound transmission. The principle of hearing reconstruction is to prioritize the improvement of air conduction hearing, followed by the advantage of bone conduction. Improvement of air-conduction hearing: implantation of open ear canals and vibrating sound bridges; utilization of bone conduction advantage: implantation of bone conduction. Therefore, there is more to hearing reconstruction than just “opening the ear canal”, and technological advances will bring more options for babies with small ears. Beethoven’s music-making stick, the bone bridge is the Beethoven’s music-making stick for the baby with small ears, and can be utilized to take advantage of bone conduction when air conduction hearing cannot be improved. Small eared child, hearing is definitely not good, hearing exam, determine the type of hearing loss, screen for that 5-10% inner ear deformity, how to improve hearing before otoplasty? Wear a bone conduction hearing aid.