I. Congenital ear malformation Due to the influence of heredity, chromosomal aberrations and internal and external environmental factors, malformations of the outer ear, middle ear and inner ear can occur. Among them, malformations of the auricle, external auditory canal and middle ear often coexist, and their incidence is about 1/10,000~1/12,000 newborns. Ear malformations can also be combined with malformations of the jaws, eyes, skin, bones, heart, kidneys and other organs and tissues, which are called various congenital malformation syndromes. 1.Auricular malformation, unilateral, more common in males than females, such as displaced ear, beckoning ear, large ear, small ear and secondary ear, etc. 2. Stenosis and atresia of the external auditory canal, often combined with microtia, and often combined with middle ear deformity, unilaterally. Middle ear deformities are often combined with deformities of the outer ear, but they can also exist alone, and can also be combined with inner ear deformities. 4. Inner ear malformations, which are common bilaterally and can be seen on one side, can be hereditary or can be caused by maternal infection with certain diseases during pregnancy or by X-rays, electromagnetic radiation, or drug poisoning. Most patients with congenital inner ear malformation have more severe deafness, most of them are extremely or severely deaf at birth, and some cannot hear any sound after birth; if there is malformation in the vestibule, there may be vertigo or balance disorder, but it is uncommon. Those with simple large vestibular plumbing may have normal or poor hearing at birth, but those with normal hearing may develop sudden deafness or fluctuating deafness by early childhood or youth; some patients may have vertigo and nystagmus when they receive strong sound stimulation. The timing of surgery for microtia Many patients ask about the timing of surgery for microtia in the clinic, so we will talk about it briefly here. The timing of surgery for microtia is very important. Generally speaking, the age for unilateral microtia surgery should be no younger than five years. Although auricular reconstruction can be performed in children as young as five years old, the younger the child, the higher the incidence of complications such as external canal stenosis or atresia for hearing reconstruction. The literature reports that canal stenosis is the most common complication after osseous atresia of the external auditory canal, reaching 33% to 60%. Patients with bilateral malformations usually wear hearing aids in early childhood to aid speech development, and undergo auricular reconstruction and hearing reconstruction around age 6 to allow for school attendance. For patients with unilateral deformities who have normal hearing on the opposite side, surgery can be postponed until after the age of 10 or after adulthood, when patients are more mentally mature and can understand the importance and necessity of surgery, as well as the risk of damage to the cochlea, vestibule and facial nerve (meaning no improvement or loss of hearing, vertigo and vomiting, facial palsy), and can better cooperate with surgery and postoperative care. The possibility of atresia will also be smiled. However, the following conditions need to be operated as soon as possible: congenital cholesteatoma, fistula and sinus tract around the atretic external ear canal or acute facial palsy. Post-operative complications of microtia surgery 1. Facial nerve damage: 50% of patients with microtia are accompanied by abnormalities in the direction of the facial nerve, which can easily damage the facial nerve during surgery. 2. Postoperative hearing loss: If high-frequency sensorineural deafness occurs after surgery, it is likely that the inner ear is damaged by intraoperative mechanical conduction or acoustic stimulation. 3.Stenosis or atresia of the external ear canal. 4. Vertigo and vomiting: caused by intraoperative damage to the vestibular organs or by touching the original unclosed semicircular canal, etc. 5. Other possible complications such as postoperative infection and pus flow.