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H74.1 Adhesive Middle Ear Disease – ICD-10
ICD-10 code H74.1 refers to adhesive process of the middle ear. Scarring and adhesions impair the ossicles and eardrum, leading to conductive hearing loss.
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ICD-10 code H74.1 refers to adhesive process of the middle ear. Scarring and adhesions impair the ossicles and eardrum, leading to conductive hearing loss.
What does ICD-10 Code H74.1 Mean?
The ICD-10 code H74.1 stands for adhesive process of the middle ear, also known as adhesive otitis media. This condition is characterized by abnormal scarring and adhesion of the middle ear mucosa, which progressively restricts or permanently damages the mobility of the ossicles (malleus, incus, stapes) and the tympanic membrane (eardrum), ultimately impairing sound transmission.
Causes
Adhesive process of the middle ear typically develops as a consequence of recurrent or chronic middle ear infections (otitis media). Key causes and risk factors include:
- Chronic or recurrent episodes of otitis media
- Eustachian tube dysfunction, which disrupts pressure equalization in the middle ear
- Persistent negative middle ear pressure causing retraction of the tympanic membrane
- History of tympanostomy tube insertion or prior middle ear surgery
- Unresolved serous or mucoid otitis media (glue ear)
Symptoms
Symptoms vary depending on the degree of adhesion and structural involvement:
- Conductive hearing loss: Reduced sound transmission due to restricted ossicular movement
- Sensation of fullness or blockage in the ear
- Tinnitus (ringing or buzzing in the ear)
- Recurrent ear pain or discomfort
- In severe cases: mixed hearing loss affecting both conductive and sensorineural pathways
Diagnosis
Diagnosis is established by an ENT specialist (otolaryngologist) using the following methods:
- Otoscopy: Visual inspection of the eardrum; typical findings include retraction pockets, scarring, and adhesions
- Tympanometry: Assessment of tympanic membrane compliance; adhesive disease typically produces flat (type B) or type C curves
- Audiometry: Hearing tests to quantify the degree and type of hearing loss
- CT imaging: In selected cases, computed tomography of the temporal bone to assess the extent of structural damage
Treatment
Treatment depends on the severity of the condition and the degree of hearing impairment:
Conservative Management
- Treatment of underlying Eustachian tube dysfunction (e.g., decongestants, nasal irrigation, Valsalva maneuver)
- Regular follow-up with an ENT specialist to monitor disease progression
Surgical Treatment
- Tympanoplasty: Surgical reconstruction of the eardrum and/or ossicular chain to restore hearing function
- Adhesiolysis: Surgical release of middle ear adhesions
- Insertion of tympanostomy tubes (grommets) to ventilate the middle ear
Hearing Rehabilitation
When surgical correction cannot fully restore hearing, rehabilitation with a hearing aid or an implantable hearing device may be recommended.
References
- World Health Organization (WHO): International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10). Code H74.1 – Adhesive middle ear disease.
- Gleeson M. et al. (eds.): Scott-Brown's Otorhinolaryngology, Head and Neck Surgery. 7th edition. Hodder Arnold, London 2008.
- Bluestone C.D., Klein J.O.: Otitis Media in Infants and Children. 4th edition. BC Decker, Hamilton 2007.
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