H90.0 – Bilateral Conductive Hearing Loss
H90.0 is the ICD-10 code for bilateral conductive hearing loss. It describes impaired sound transmission through the outer or middle ear on both sides.
Things worth knowing about "H90.0"
H90.0 is the ICD-10 code for bilateral conductive hearing loss. It describes impaired sound transmission through the outer or middle ear on both sides.
What is H90.0?
H90.0 is the ICD-10 diagnosis code for bilateral conductive hearing loss. In this type of hearing loss, the mechanical transmission of sound waves through the outer ear canal or middle ear is impaired on both sides. The inner ear (cochlea) and the auditory nerve typically function normally.
Causes
Bilateral conductive hearing loss can result from a variety of conditions, including:
- Earwax blockage (cerumen impaction): Bilateral obstruction of the ear canal by hardened earwax.
- Otitis media: Inflammation of the middle ear, often accompanied by fluid accumulation.
- Otitis media with effusion (glue ear): Accumulation of non-infected fluid behind the eardrum.
- Tympanic membrane perforation: A tear or hole in the eardrum on both sides.
- Otosclerosis: Abnormal bone growth fixating the stapes (stirrup bone) in the middle ear.
- Congenital malformations: Structural abnormalities of the outer or middle ear present from birth.
- Trauma: Injury to the eardrum or the ossicular chain.
Symptoms
Common symptoms associated with H90.0 include:
- Bilateral hearing reduction, varying in severity by cause
- Muffled or dampened perception of sound
- Sensation of pressure or fullness in the ears
- Tinnitus (ringing in the ears) in some cases
- Difficulties with speech perception and communication
- In children: delayed speech and language development
Diagnosis
Bilateral conductive hearing loss is diagnosed by an ear, nose and throat (ENT) specialist using several assessments:
- Otoscopy: Direct inspection of the ear canal and eardrum
- Pure-tone audiometry: Measurement of hearing thresholds at various frequencies; an air-bone gap is characteristic of conductive hearing loss
- Tympanometry: Assessment of eardrum mobility and middle ear function
- Tuning fork tests (Weber and Rinne): Simple bedside tests to differentiate conductive from sensorineural hearing loss
- Imaging (CT/MRI): Used when structural abnormalities or congenital malformations are suspected
Treatment
Treatment depends on the underlying cause of the hearing loss:
- Earwax removal: Manual or irrigation-based removal of cerumen plugs
- Antibiotics or anti-inflammatory medications: For bacterial middle ear infections
- Tympanostomy tubes (grommets): Small ventilation tubes inserted into the eardrum to drain fluid from the middle ear
- Surgical procedures: Such as tympanoplasty for eardrum repair, or stapedectomy/stapedotomy for otosclerosis
- Hearing aids: For residual hearing loss that cannot be fully corrected surgically
- Bone-anchored hearing systems (BAHA): For severe conductive hearing loss when conventional hearing aids are not suitable
Special Considerations in Children
In children, bilateral conductive hearing loss requires prompt attention, as it can significantly affect speech and language development and academic performance. The most common cause in children is otitis media with effusion (glue ear), which is often managed with the insertion of tympanostomy tubes. Early diagnosis and treatment are essential to support normal developmental outcomes.
References
- World Health Organization (WHO): ICD-10 Version 2019, Chapter VIII – Diseases of the Ear and Mastoid Process. Available at: https://icd.who.int/
- Dhingra PL, Dhingra S: Diseases of Ear, Nose and Throat & Head and Neck Surgery. 7th edition. Elsevier, 2018.
- Rosenfeld RM et al.: Clinical Practice Guideline: Otitis Media with Effusion (Update). Otolaryngology–Head and Neck Surgery. 2016;154(1 Suppl):S1-S41.
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