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H90.2 – Bilateral Conductive Hearing Loss

H90.2 is the ICD-10 code for bilateral conductive hearing loss, where the transmission of sound through the outer or middle ear is impaired, leading to reduced hearing.

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Things worth knowing about "H90.2"

H90.2 is the ICD-10 code for bilateral conductive hearing loss, where the transmission of sound through the outer or middle ear is impaired, leading to reduced hearing.

Definition

H90.2 is a diagnosis code from the ICD-10 classification system (International Classification of Diseases, 10th Revision). It refers to bilateral conductive hearing loss, a condition in which the transmission of sound waves from the outer ear through the middle ear to the inner ear is disrupted. The inner ear and auditory nerve are typically not affected in purely conductive hearing loss.

Causes

Conductive hearing loss can result from a variety of conditions affecting the outer or middle ear:

Earwax blockage (cerumen impaction): Accumulation of earwax that obstructs the ear canal.
Middle ear infection (otitis media): Inflammation of the middle ear, often associated with fluid build-up.
Glue ear (otitis media with effusion): Non-infectious fluid accumulation behind the eardrum.
Eardrum perforation: A hole or tear in the eardrum caused by trauma, infection, or pressure changes.
Otosclerosis: Abnormal bone growth in the middle ear that restricts the movement of the ossicles (small bones).
Congenital malformations: Structural abnormalities of the outer or middle ear present from birth.
Foreign bodies in the ear canal: Especially common in children.

Symptoms

Typical symptoms of bilateral conductive hearing loss include:

Reduced hearing ability in both ears
Muffled or dull perception of sounds
A sensation of pressure or fullness in the ears
Difficulty understanding speech, particularly in noisy environments
Possible accompanying tinnitus (ringing in the ears)

Diagnosis

Diagnosis is established through a combination of clinical examinations:

Otoscopy: Visual inspection of the ear canal and eardrum.
Pure-tone audiometry: Measures hearing ability across different frequencies; conductive hearing loss shows an air-bone gap.
Tympanometry: Assesses the mobility of the eardrum and middle ear function.
Weber and Rinne tests: Tuning fork tests used to distinguish between conductive and sensorineural hearing loss.

Treatment

Treatment depends on the underlying cause of the conductive hearing loss:

Earwax removal by irrigation or microsuction of the ear canal.
Antibiotics or corticosteroids for inflammatory middle ear conditions.
Myringotomy or ventilation tubes for persistent fluid in the middle ear.
Surgical interventions such as tympanoplasty (eardrum repair) or stapedectomy (for otosclerosis).
Hearing aids may be used when surgical correction is not feasible or not desired by the patient.

References

World Health Organization (WHO): International Classification of Diseases, 10th Revision (ICD-10) – H90.2 Conductive hearing loss, bilateral. who.int
Lalwani A.K.: Current Diagnosis and Treatment in Otolaryngology – Head and Neck Surgery. 4th edition, McGraw-Hill Education, 2020.
Bhattacharyya N. et al.: Clinical Practice Guideline: Sudden Hearing Loss. Otolaryngology – Head and Neck Surgery, 2019. PubMed PMID: 31369381.

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