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H72.8 – Other Tympanic Membrane Perforation | ICD-10
H72.8 is the ICD-10 code for other perforations of the tympanic membrane – a hole or tear caused by infection, injury, or pressure changes.
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H72.8 is the ICD-10 code for other perforations of the tympanic membrane – a hole or tear caused by infection, injury, or pressure changes.
What is H72.8?
The ICD-10 code H72.8 refers to other perforations of the tympanic membrane – forms of eardrum defects that do not fall under more specific subcategories of the ICD group H72. A tympanic membrane perforation is a hole or tear in the eardrum (membrana tympani), the thin membrane that separates the external ear canal from the middle ear. The eardrum plays a central role in sound transmission and protects the middle ear from bacteria, viruses, and fluid.
Causes
Tympanic membrane perforations can result from a variety of causes:
- Middle ear infection (otitis media): Acute or chronic inflammation of the middle ear is the most common cause. A buildup of pus can increase pressure and rupture the eardrum.
- Barotrauma: Sudden pressure changes during diving, flying, or explosions can tear the eardrum.
- Mechanical injury: Improper ear cleaning (e.g., with cotton swabs), foreign objects, or a direct blow to the ear can cause perforation.
- Acoustic trauma: Extremely loud noises or blast waves can damage the eardrum tissue.
- Chronic inflammation: Long-standing middle ear disease or cholesteatoma can lead to tissue destruction and perforation.
Symptoms
Symptoms depend on the size and cause of the perforation. Common signs include:
- Hearing loss (often perceived as muffled hearing)
- Ear pain, especially at the time of the acute event
- Tinnitus (ringing in the ear)
- Ear discharge (otorrhea), particularly when infection is present
- Dizziness or balance problems (in more severe cases)
Diagnosis
Diagnosis is primarily clinical and may involve:
- Otoscopy: Direct visualization of the eardrum using an otoscope. A hole or tear is often clearly visible.
- Audiometry: Hearing tests to assess the degree of any associated hearing loss.
- Tympanometry: Measurement of eardrum mobility, which is altered when a perforation is present.
- Imaging: CT scanning of the temporal bone may be performed in complex cases or when complications such as cholesteatoma are suspected.
Treatment
Treatment depends on the cause, size of the perforation, and any accompanying conditions:
Conservative Management
- Small perforations often heal spontaneously within several weeks.
- Protection from moisture: The ear should be kept dry during bathing or swimming (e.g., using earplugs or cotton with petroleum jelly).
- Antibiotic ear drops if infection is present.
- Analgesics for pain relief.
Surgical Treatment
- Myringoplasty: Surgical closure of the eardrum using autologous tissue (e.g., temporalis fascia). Indicated for larger or persistent perforations.
- Tympanoplasty: A more extensive surgical procedure when middle ear structures are also involved.
Prognosis
Most uncomplicated tympanic membrane perforations heal well with or without treatment. Hearing loss is generally reversible after healing. Larger defects, chronic infections, or complications such as cholesteatoma or inner ear damage may require specialist intervention.
References
- World Health Organization (WHO): International Classification of Diseases, 10th Revision (ICD-10). Chapter VIII – Diseases of the Ear and Mastoid Process, H72.8. Geneva: WHO, 2019.
- Lalwani AK: Current Diagnosis and Treatment in Otolaryngology – Head and Neck Surgery. 4th ed. McGraw-Hill Education, New York, 2020.
- Qureishi A et al.: Update on otitis media – prevention and treatment. Infection and Drug Resistance. 2014;7:15–24. doi:10.2147/IDR.S39637
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