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The patient is a 20-year-old male who has a long history of left chronic otitis media. The patient has failed numerous medical treatments. During the examination in the ENT physician’s office, he was found to have a large cholesteatoma filling up the left auditory canal. The left external the canal was also filled with pus. This physician has treated the patient for several years and suspects there may be the destruction of the incus, malleus, stapes, and stapes footplate as a result of the long-term ear infections. In the official record, the physician wrote the diagnosis cholesteatoma left external ear and left chronic otitis media. The patient was admitted for an open left mastoidectomy and total ossicular replacement procedure (with synthetic device) (TORP) so that his comorbid condition of Marfan’s syndrome with associated cardiovascular conditions, namely aortic dilation, could be monitored with the associated risks manage
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