The cause of congenital microtia is complex and still unknown. It may be related to inbreeding of the parents, or to the mother’s exposure to drugs, radiation, harmful gases, etc. or viral infections during the early stages of pregnancy (around 2-3 months). The main manifestations are malformation of the auricle on one or both sides, absence of an auricular opening or narrowing of the auricular canal, and low hearing on that side. Bilateral malformations of the ear can seriously affect the child’s speech and language development, resulting in slurred speech. The child will not be able to communicate properly with family and friends and will not be able to attend regular school. This can have a significant impact on the child’s physical and mental development. So if both ears are poorly heard, then early surgery is required. Surgery is usually performed when the child is six or seven years old to improve hearing on at least one side so that the child can attend school normally. Poor hearing on one side can affect the child’s ability to hear in both ears in three dimensions, making speech discrimination less effective. The significant asymmetry of the head and face can also cause a lot of stress in the child’s mind and lead to the formation of low self-esteem and even autism. Therefore, we recommend that children with unilateral external middle ear deformity should have their hearing reconstructed as much as possible to form binaural three-dimensional hearing, while protecting the facial nerve, meninges, temporomandibular joint and other important structures. However, in children with unilateral external middle ear deformity, we generally recommend waiting until the age of 15 or so to perform the surgery. On the one hand, the reconstructed ear canal is less likely to be narrowed again. On the other hand, the child’s rib cartilage is more fully developed and more tolerant of the surgery. However, it is important not to wait too late for the surgery, because in adulthood, the rib cartilage will ossify and affect the shape of the auricular scaffold. Surgery is performed in two stages, with an interval of at least three months, and six months to a year is ideal, preferably not more than two years, otherwise the cartilage may undergo liquefaction and absorption. Since most children are at the age of adolescent sebum production and active age, both children and parents should pay special attention to avoid squeezing and collision as well as ear acne infection during the entire two-stage surgery. If problems such as redness, pus, pain or even surface skin breakdown of the ear occur, they should be reviewed at any time to avoid more serious consequences.