Microtia mostly develops unilaterally. Our statistics show that 75% of patients with microtia are unilateral, with the right side being more prevalent and the proportion of men and women being slightly higher. Patients with microtia often develop atresia of the ear canal, resulting in moderate to severe conductive deafness. Because one ear is normal, speech development is usually not impaired in these patients, so treatment of patients with unilateral microtia has previously focused on auricular reshaping rather than on hearing reconstruction in the affected ear. With the advancement of auditory research, the need for hearing reconstruction in patients with unilateral microtia is gradually being recognized by otologists and audiologists. Normal people have bilateral hearing and therefore have the ability to localize sound sources and to recognize speech in noisy environments. In contrast, patients with unilateral microtia, who have only one side of the hearing, have difficulty identifying the source of sound and perform poorly in noisy environments. In clinical practice, many children with unilateral microtia with atresia are able to form speech normally; however, in complex auditory environments (classes, group conversations, noisy backgrounds), there is a gap between the patient’s auditory and communication abilities compared to normal individuals. Therefore, in patients with unilateral microtia with associated aural atresia (presenting with moderate to severe conductive deafness), the treatment strategy should be a combination of hearing reconstruction and otoplasty. This treatment strategy has been generally accepted in Western countries, but currently in China, many patients with unilateral microtia (or the parents of the child) still do not know much about hearing reconstruction. This lag in understanding has caused many unilateral children to miss the best time for hearing reconstruction; moreover, traditional hearing reconstruction surgery can damage the flap area needed for auricular reconstruction and affect future auricular reconstruction, so doctors usually can only perform hearing reconstruction after auricular reconstruction.