Let's take a look at what microtia is: congenital microtia, or congenital external and middle ear malformation, which is characterized by severe hypoplasia of auricle, atresia or stenosis of external auditory canal and middle ear malformation, while the inner ear is mostly normal in development and has certain hearing through bone conduction. It needs to be treated by total ear reconstruction and auditory function reconstruction.

Hearing reconstruction

Most patients with congenital microtia have atresia of external auditory canal. When parents take their children to see a doctor, they are often most concerned about hearing, thinking that the child's ear is completely deaf, or a hole in the skin can completely restore hearing. In this regard, doctors should explain hearing problems from the embryonic development of ears and correct their misconceptions.

During embryonic development, the middle ear and external ear mainly come from the first and second branchial arches. At 5-week-old embryo, the auricle appears in the form of six hills on these two branchial arches, while the inner ear appears at 3-week-old embryo, and the inner ear comes from ectodermal tissue. Due to different tissue sources, patients with microtia are mainly developmental malformations of the outer ear and middle ear, and the inner ear is often not involved. There are two ways for sound to reach people's inner ear. The way from the outer ear to the middle ear and then to the inner ear is called air conduction, and microtia has air conduction disorder. The transmission of sound from the skull to the inner ear is called bone conduction. The bone conduction of microtia exists, and it can also be heard for loud sounds.

Generally speaking, the hearing of the affected side of unilateral microtia is about 40%, and the hearing of the healthy side is normal, which has little influence on language pronunciation and daily life except for poor judgment direction. Therefore, it has been controversial whether such patients should undergo external auditory canal plasty to improve their hearing. The main objection is that there are many surgical complications, and the improvement of their hearing is very small and often not lasting. In recent years, with the development of technology, otologists tend to operate. There are also differences between otologists and plastic surgeons in the order of surgery. The lack of elasticity of reconstructed ear will affect the operation of otologists, but the skin in mastoid region often leaves scars after external auditory canal surgery, which affects plastic surgeons to make full use of this skin for auricle reconstruction. However, as long as the position of the reconstructed ear is preserved, experienced otologists can also carry out hearing reconstruction after auricle reconstruction.

I hope the above information is helpful to you. If you have any questions, you can ask Professor Wu Jianming.