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H74.0 Tympanosclerosis – Causes & Treatment
H74.0 is the ICD-10 code for tympanosclerosis, a middle ear condition characterized by calcified plaques in the eardrum or tympanic cavity, often causing conductive hearing loss.
Things worth knowing about "H74.0"
H74.0 is the ICD-10 code for tympanosclerosis, a middle ear condition characterized by calcified plaques in the eardrum or tympanic cavity, often causing conductive hearing loss.
What is H74.0 – Tympanosclerosis?
The ICD-10 code H74.0 refers to tympanosclerosis, a condition of the middle ear characterized by the deposition of calcified and fibrous plaques within the tympanic membrane (eardrum) and the tympanic cavity. These hardened deposits can reduce the mobility of the eardrum and the ossicles (the small bones of the middle ear), resulting in conductive hearing loss.
Causes
Tympanosclerosis typically develops as a result of chronic or recurrent middle ear inflammation (otitis media). Common causes and risk factors include:
- Repeated acute middle ear infections, especially during childhood
- Chronic otitis media (long-term middle ear infection)
- Prolonged use of tympanostomy tubes (ear grommets)
- Traumatic perforation of the tympanic membrane
- Immune-mediated responses to repeated infections
Recurrent inflammatory processes lead to overproduction of collagen and subsequent deposition of calcium salts within the connective tissue of the middle ear.
Symptoms
The symptoms of tympanosclerosis vary depending on the extent of calcification:
- Conductive hearing loss: The most common complaint, caused by reduced vibration capacity of the eardrum and ossicles
- Sensation of pressure or fullness in the ear
- Mild tinnitus (ringing in the ear) in some cases
- In mild cases, symptoms may be minimal or absent
In severe cases, hearing impairment can be significant and considerably affect the quality of life of those affected.
Diagnosis
Tympanosclerosis is diagnosed by an ear, nose and throat (ENT) specialist using the following examinations:
- Otoscopy / Ear microscopy: Visible whitish plaques on the tympanic membrane
- Tympanometry: Measurement of eardrum mobility to assess sound conduction
- Pure-tone audiogram: Assessment of the degree of hearing loss
- Computed tomography (CT) of the temporal bone: When extensive calcification in the tympanic cavity is suspected
Treatment
Treatment depends on the severity of the condition and the degree of hearing impairment:
Conservative Management
In mild tympanosclerosis without significant hearing loss, a watchful waiting approach with regular ENT follow-up may be sufficient.
Surgical Treatment
- Tympanoplasty: Surgical removal of calcified plaques and reconstruction of the tympanic membrane and ossicular chain
- Ossiculoplasty: Reconstruction of the ossicles in cases of severe involvement
Hearing Aid Fitting
When surgery is not feasible or not desired, hearing aids can effectively compensate for conductive hearing loss and improve communication ability.
References
- World Health Organization (WHO): International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10). Geneva, 2019.
- Browning G.G., Merchant S.N., Kelly G. et al.: Chronic Otitis Media. In: Scott-Brown's Otorhinolaryngology, Head and Neck Surgery, 7th edition. Hodder Arnold, London, 2008.
- Giddings N.A., Brackmann D.E.: Tympanosclerosis. In: Otolaryngologic Clinics of North America, 27(3):655–664, 1994.
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