Parents often ask if their baby’s small ears are the cause of their scratchy ears lately. Can baby’s small ears cause big and small faces? Baby’s ears are just not open, will they grow out after pulling them? If the baby doesn’t have a big or small face now, will he/she have one in the future? Can small ears cause otitis media? Our baby’s ear has a small eye on the surface where the ear canal is, is it an ear canal? Our baby is one year old and doesn’t respond to being called, can we open the ear canal for our baby? I am sure there are many parents who have thought about such questions. So with regard to these kinds of questions, in addition to this article, parents of babies with small ears or patients and friends should also read other scientific articles. So here’s what we have to say about little ears in relation to ear scratching, big and small faces, otitis media, and ear canals. Ear Scratching First of all, ear scratching is an action that all infants and toddlers are likely to do. Most babies scratch their ears for four reasons: acute otitis media, external ear canal eczema, otitis externa, or cerumen. Infants and children are at high risk of otitis media, firstly because of poor immunity, and secondly because of the physiological structure of the Eustachian tube, which is shorter, flatter and straighter in children and infants than in adults. Therefore, if a baby with small ears scratches its ears and cries, parents should consider otitis media. Eczema, otitis externa and cerumen occur in the external auditory canal. Usually patients with atresia of the external auditory canal do not need to consider these three factors. Eczema of the external auditory canal is an allergic dermatitis caused by a variety of factors, with oozing (running water) and itching in the external auditory canal, which tends to recur; otitis externa is a localized inflammation caused by a variety of factors, with discomfort or itching in the external auditory canal. Cerumen, commonly known as earwax, is a secretion from the sebaceous glands of the ceruminous glands of the cartilaginous skin of the external auditory canal, which protects the skin of the external auditory canal and adheres to dust. Because of the presence of cerumen, some babies occasionally have itchy ears and scratching. If there is redness and swelling of the ears, fever does not go down, and crying, parents should take the affected children to the hospital, and should not use medication on their own. Small face Small ears, the full name of congenital malformation of the external middle ear. As the name suggests, small ears occur alone, usually only the outer middle ear malformation, not accompanied by other deformities (such as large and small face, congenital facial paralysis). Because the ear and other organs develop independently from different embryonic tissues and at different times of development, ear malformations do not cause malformations in other organs. In contrast, most malformations that occur in combination are problems with all five senses or some of the facial organs at the same time, such as Treacher Collins Syndrome, which combines malformations of the eyes, ears, jaw, face, mouth, and other organs. Microtia does not cause a “big face”, but it needs to be considered at a later stage of treatment. In less severe cases, the “big face” can be improved by exercising the facial muscles through physical therapy such as massage; in severe cases, surgical treatment can be considered. Opening the ear canal The ear canal of the small ear is partly narrow or even atresia. “Opening the ear canals is for atresia, and the main purpose is to improve hearing. There are many factors that affect the opening of the ear canal, the most important being age and development. In China, autologous rib cartilage is mostly used for auricular reconstruction. Depending on the development of the autologous rib cartilage, the appropriate age for auricular reconstruction is usually between 6 and 10 years old. The “opening of the ear canal” is usually performed at the same time or after the completion of the auricular reconstruction. This also limits the duration of the “open ear canal” procedure. Aperture surgery to improve hearing is based on the development of the outer and middle ear to assess the hearing after aperture surgery. If the combined outer and middle ear scores are high and the expected hearing after the surgery is good, then the surgery can be performed; if the development is poor and the expected hearing is not good, then there is little point in performing the surgery. Another point to consider is the patient’s physical condition. Scarred patients should not have their ears opened. Stenosis of the external auditory canal, as the name implies, means that the diameter of the external auditory canal is smaller than that of a normal ear canal. In patients with small ears, the narrowing of the ear canal must be accompanied by varying degrees of middle ear deformity, and the hearing must be abnormal as well, just with different degrees of severity. Therefore, if the middle ear is well developed and the degree of deformity is slightly less severe, the hearing after the surgery is better and lasts longer; if the middle ear is poorly developed, or if there is a severe inner ear deformity, traditional hearing reconstruction surgery cannot be performed. “After the surgery, you will need to go to the hospital regularly to clean the ear canal and monitor the condition of the ear canal and your hearing at all times.