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H80.2 – Otosclerosis Involving the Cochlea
H80.2 is the ICD-10 code for otosclerosis involving the cochlea. This condition causes progressive hearing loss due to abnormal bone remodeling in the inner ear.
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H80.2 is the ICD-10 code for otosclerosis involving the cochlea. This condition causes progressive hearing loss due to abnormal bone remodeling in the inner ear.
What is H80.2? – Otosclerosis Involving the Cochlea
The ICD-10 code H80.2 refers to otosclerosis involving the cochlea. In this form of otosclerosis, not only the middle ear but also the cochlea (the spiral-shaped hearing organ of the inner ear) is affected by abnormal bone remodeling. This leads to a mixed hearing loss combining conductive and sensorineural components, making it a clinically significant subtype of otosclerosis.
Causes
The exact causes of otosclerosis are not yet fully understood. The main contributing factors include:
- Genetic predisposition: Otosclerosis tends to run in families and follows an autosomal dominant inheritance pattern with incomplete penetrance.
- Hormonal influences: A link with estrogen is suspected, as symptoms often worsen during pregnancy.
- Viral infections: There is evidence suggesting a possible association with the measles virus.
- Immunological factors: Inflammatory and autoimmune processes may also play a role in disease progression.
Symptoms
Patients with otosclerosis involving the cochlea (H80.2) may experience the following symptoms:
- Progressive hearing loss: Initially presenting as conductive hearing loss, later developing into mixed hearing loss as the cochlea becomes involved.
- Tinnitus: Ringing or buzzing in the ears, often described as low-frequency noise.
- Dizziness: May occur when the cochlea is significantly affected, though less common than hearing loss.
- Paracusis Willisii: A phenomenon where affected individuals paradoxically hear better in noisy environments than in quiet ones.
Diagnosis
The diagnosis of otosclerosis with cochlear involvement is based on a combination of clinical and audiological assessments:
- Audiometry: Pure-tone audiograms typically reveal mixed hearing loss with a characteristic dip in bone conduction at 2000 Hz, known as the Carhart notch.
- Tympanometry: Measures middle ear function and may reveal reduced tympanic membrane mobility.
- CT scan of the temporal bone: Imaging to visualize bony changes around the cochlea and stapes.
- ENT examination: Physical inspection of the eardrum, which typically appears normal in otosclerosis.
Treatment
Surgical Treatment
Stapedectomy or stapedotomy (surgical procedures on the stapes bone) are the preferred treatments when the conductive component is predominant. The fixed stapes is replaced with a prosthesis to restore sound transmission. However, when cochlear involvement is present, surgical outcomes may be limited as the inner ear component cannot be addressed through this approach.
Hearing Aids and Cochlear Implants
When there is significant sensorineural hearing loss and surgery is not fully effective, hearing aids are considered. In cases of severe to profound inner ear hearing loss, a cochlear implant (CI) may offer an effective rehabilitation option.
Medical Therapy
Sodium fluoride has been used in some countries to slow disease progression by stabilizing the abnormal bone remodeling process. However, scientific evidence for this therapy remains limited and it is not universally recommended in current guidelines.
References
- World Health Organization (WHO): ICD-10 Classification of Mental and Behavioural Disorders – H80.2 Otosclerosis involving cochlea. Geneva, 2019.
- Declau F, Van de Heyning P: Otosclerosis. In: Ballenger's Otorhinolaryngology Head and Neck Surgery. 17th edition. PMPH-USA, 2009.
- Chole RA, McKenna M: Pathophysiology of otosclerosis. Otology & Neurotology. 2001;22(2):249–257. PubMed PMID: 11300267.
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