Cholesteatoma of attic, bilateral
ICD-10 H71.03 is a billable code used to indicate a diagnosis of cholesteatoma of attic, bilateral.
Cholesteatoma of the attic is a destructive and expanding growth of skin cells in the middle ear and/or mastoid process. This condition often arises from chronic otitis media, leading to the accumulation of skin debris and infection. Bilateral cholesteatomas indicate that the condition affects both ears, which can complicate management and increase the risk of hearing loss. Patients may present with symptoms such as ear discharge, hearing loss, tinnitus, and sometimes vertigo. Diagnosis typically involves otoscopic examination, imaging studies like CT scans, and audiometric testing to assess hearing function. Management often requires surgical intervention to remove the cholesteatoma and reconstruct the tympanic membrane, with follow-up care to monitor for recurrence. The chronic nature of cholesteatomas and their potential complications, including mastoiditis and intracranial infections, necessitate careful monitoring and management.
Detailed history of ear symptoms, audiometric results, imaging studies, and surgical notes.
Patients presenting with chronic ear infections, hearing loss, or post-surgical follow-up for cholesteatoma.
Ensure clear documentation of the extent of cholesteatoma and any complications.
Comprehensive audiometric evaluations and reports on hearing loss related to cholesteatoma.
Assessment of hearing loss in patients with known cholesteatoma.
Document the impact of cholesteatoma on hearing thresholds and speech discrimination.
Performed to remove cholesteatoma and reconstruct the tympanic membrane.
Operative report detailing the procedure and findings.
Otolaryngology specialists must document the extent of disease and surgical approach.
Bilateral coding indicates that both ears are affected, which can influence treatment decisions, surgical approaches, and the overall management plan for the patient.
