Name of the Condition

• Attic Perforation of Tympanic Membrane, Bilateral
• Also known as bilateral attic perforation.

Summary

• This condition involves a perforation or hole in the upper part (attic) of the tympanic membrane (eardrum) in both ears, which can affect hearing and lead to potential infections.

Causes

• Commonly caused by chronic ear infections or trauma.
• It may also occur due to conditions leading to increased middle ear pressure or chronic eustachian tube dysfunction.

Risk Factors

• Recurrent ear infections.
• History of middle ear diseases.
• Frequent or untreated upper respiratory infections.
• Smoking and exposure to tobacco smoke.
• Use of cotton swabs or other objects to clean the ears.

Symptoms

• Hearing loss or reduction in both ears.
• Ear pain or discomfort.
• Discharge from the ear canal.
• Tinnitus or ringing in the ears.
• Vertigo or dizziness in some cases.

Diagnosis

• Physical examination using an otoscope to inspect the tympanic membrane.
• Audiometric tests to assess hearing loss.
• Tympanometry to evaluate eardrum movement.
• CT or MRI scans in complex cases for detailed imaging.

Treatment Options

• Observation and Monitoring: For minor, non-infected perforations.
• Antibiotics: To treat or prevent infections.
• Myringoplasty or Tympanoplasty: Surgical procedures to repair the perforation.
• Hearing Aids: May be recommended if hearing loss persists.

Prognosis and Follow-Up

• Prognosis is generally good with appropriate treatment.
• Regular follow-ups are important to monitor hearing and ensure that the repair of the tympanic membrane is successful.

Complications

• Persistent hearing loss.
• Frequent ear infections.
• Potential for chronic drainage.
• Risk of cholesteatoma formation, which may require surgical intervention.

Lifestyle & Prevention

• Avoid inserting objects into the ears.
• Manage and treat upper respiratory tract infections promptly.
• Avoid smoking and exposure to secondhand smoke.
• Use ear protection in noisy environments.

When to Seek Professional Help

• Persistent or severe ear pain.
• Sudden change in hearing.
• Continuous ear discharge or bleeding.
• Symptoms of dizziness or vertigo.

Additional Resources

• American Academy of Otolaryngology — Head and Neck Surgery (https://www.entnet.org/)
• Hearing Health Foundation (https://hearinghealthfoundation.org/)

Tips for Medical Coders

• Code H72.13 specifically for bilateral perforation of the attic of the tympanic membrane.
• Ensure documentation specifies bilaterality to apply correct ICD coding.
• Avoid miscoding as unilateral perforation, which requires different codes.