H65.23 Chronic serous otitis media, bilateral

ICD10CM code

#### Name of the Condition
- Chronic Serous Otitis Media, Bilateral
- Also known as "glue ear" when referring to the chronic effusion in the middle ear.

#### Summary
Chronic Serous Otitis Media, Bilateral is a condition marked by the persistent accumulation of non-infected fluid in both middle ears, behind the eardrum. It is most common in children and can affect hearing.

#### Causes
- Dysfunction of the Eustachian tube, which connects the middle ear to the throat, leading to fluid buildup.
- May follow an acute ear infection (otitis media).
- Allergies or respiratory tract infections.

#### Risk Factors
- Young age (children between 6 months and 2 years).
- Group daycare attendance.
- Exposure to tobacco smoke.
- Bottle feeding while lying down.
- Male gender may have a slight predisposition.

#### Symptoms
- Hearing impairment.
- Sensation of fullness in the ears.
- Occasional balance problems.
- Speech development issues in children.

#### Diagnosis
- Otoscopic examination showing fluid behind the eardrum.
- Tympanometry to measure eardrum movement.
- Hearing tests to assess the degree of hearing loss.

#### Treatment Options
- Watchful waiting, as the condition often resolves on its own.
- Hearing aids for temporary hearing improvement.
- Autoinflation devices to open the Eustachian tube.
- Surgical insertion of ear tubes (grommets) to drain the fluid.
- Adenoidectomy if enlarged adenoids are a contributing factor.

#### Prognosis and Follow-Up
- With treatment, many recover fully with no long-term effects.
- Regular hearing assessments are crucial for children to prevent developmental delays.
- Follow-up visits may be needed to monitor fluid levels and hearing improvement.

#### Complications
- Persistent hearing loss.
- Speech and language delays.
- Possible development of acute ear infections.

#### Lifestyle & Prevention
- Reduce exposure to irritants like tobacco smoke.
- Promote breastfeeding, which may decrease the risk of ear infections.
- Educate parents on appropriate feeding positions to reduce risk.

#### When to Seek Professional Help
- Persistent symptoms beyond 3 months.
- Noticeable hearing loss or speech delays in children.
- Recurrent ear infections.

#### Additional Resources
- American Academy of Pediatrics (AAP)
- National Institute on Deafness and Other Communication Disorders (NIDCD)
- Support groups for parents and caregivers.

#### Tips for Medical Coders
- Ensure bilateral condition is correctly documented.
- Distinguish from acute otitis media and unilateral cases.
- Verify the chronic nature of the condition to avoid coding errors with acute cases.

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