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H90.6 – Unilateral Mixed Hearing Loss | ICD-10
H90.6 is the ICD-10 code for mixed conductive and sensorineural hearing loss in one ear with unrestricted hearing on the contralateral side.
Add as Preferred SourceThings worth knowing about "H90.6"
H90.6 is the ICD-10 code for mixed conductive and sensorineural hearing loss in one ear with unrestricted hearing on the contralateral side.
What Does ICD-10 Code H90.6 Mean?
The ICD-10 code H90.6 refers to mixed conductive and sensorineural hearing loss affecting one ear, while the other ear has normal hearing ability. This condition is also called unilateral mixed hearing loss. The combination of a conductive and a sensorineural component indicates that both the sound-conducting apparatus (ear canal, middle ear) and the sound-perceiving part (inner ear, auditory nerve) are affected on the same side.
Causes
Mixed hearing loss can result from various diseases and injuries. The most common causes include:
- Chronic otitis media: Persistent middle ear inflammation that damages both middle and inner ear structures
- Otosclerosis: Abnormal bone remodeling in the middle ear that can later affect the inner ear
- Tympanic membrane perforation combined with inner ear damage
- Cholesteatoma: Abnormal skin growth in the middle ear that erodes surrounding structures
- Trauma: Acoustic trauma, blunt head injury, or skull base fracture
- Age-related changes combined with structural middle ear pathology
Symptoms
As H90.6 describes a unilateral hearing loss, symptoms are confined to one ear:
- Reduced hearing ability in one ear
- Difficulty understanding speech, especially in noisy environments
- Problems localizing the direction of sounds
- Possible sensation of pressure or fullness in the affected ear
- Occasional tinnitus (ringing in the ear) on the affected side
- Dizziness may accompany the hearing loss in some cases
Diagnosis
Diagnosis of mixed hearing loss requires a comprehensive audiological and ENT examination:
- Pure-tone audiometry: Standard test measuring hearing thresholds at different frequencies; reveals both air conduction and bone conduction impairment
- Tympanometry: Assessment of middle ear function and eardrum compliance
- Stapedius reflex testing: Evaluation of the acoustic reflex response
- Speech audiometry: Assessment of speech recognition ability
- Imaging (CT or MRI of the temporal bone): Indicated when structural abnormalities of the middle or inner ear are suspected
Treatment
Therapy is guided by the underlying cause and the severity of hearing loss:
Conservative Treatment
- Management of acute infections with antibiotics or decongestants
- Hearing aid fitting to improve hearing function
Surgical Treatment
- Tympanoplasty: Surgical reconstruction of the eardrum and ossicular chain
- Stapedoplasty for otosclerosis: Replacement of the fixed stapes with a prosthesis
- Cholesteatoma surgery: Surgical removal of cholesteatoma tissue
Hearing Devices
- Conventional hearing aids (fitted by hearing care professionals)
- Bone-anchored hearing systems (e.g., BAHA) for suitable candidates
- Cochlear implants in cases of severe inner ear hearing loss
References
- World Health Organization (WHO): ICD-10 International Classification of Diseases, 10th Revision. Chapter VIII: Diseases of the Ear and Mastoid Process (H60-H95). WHO, Geneva.
- Flint P.W. et al.: Cummings Otolaryngology: Head and Neck Surgery, 7th Edition. Elsevier, Philadelphia 2020.
- Lustig L.R., Limb C.J.: Mixed Hearing Loss – Diagnosis and Management. UpToDate, Wolters Kluwer, 2023.
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