Clinical Indicators
Canalith Repositioning
(Otolith Repositioning; Epley Maneuver; Semont Maneuver)
| Approach Procedure | CPT | FUD |
| Unlisted Otorhinolaryngological Service or Procedure | 92700 | XXX |
Indications
1. History
| a) | Description of vertigo |
| b) | Functional impairment due to vertigo |
| c) | History of head trauma |
| d) | History of upper respiratory infection |
| e) | No evidence of neck or back disorders that might contraindicate this manuever |
2. Physical Examination
| a) | Neurotologic examination:
|
| b) | Cerebellar examination |
| c) | Carotid artery auscultation |
3. Tests (optional)
|
Outcome Review
1. First Month| a) | Presence or absence of positional vertigo |
| a) | Presence or absence of positional vertigo |
| b) | Resumption of normal life style |
| c) | Consideration for further evaluation if symptoms persist. |
Additional Information
Assistant Surgeon - None
Supply Charges - L0120 Cervical Collar
Anesthesia Codes - None
Patient Information
Benign positional vertigo is one of the most common causes of dizziness seen by the otolaryngologist. This inner ear problem is caused by crystals floating in the fluid of the inner ear. On position change, these crystals stimulate part of the inner ear and produce short periods of dizziness. Causes for the crystals to break away are: head injuries, decreased blood to the inner ear, degenerative diseases, and viral infections of the inner ear or are unknown. This process usually takes from one to twelve months to occur. In time, these crystals will settle and the symptoms will go away.
The crystals can be repositioned to shorten the time it takes for positional vertigo to resolve. This repositioning is called the Epley or Semont maneuver. This is a simple in-office therapy that takes about 30 minutes. The patient is placed in several different positions during the maneuver which usually causes temporary dizziness. Patients may wear a neck collar overnight to help keep the head and neck in position. Many patients have improvement with this treatment or repeated treatments.
Important Notice
The Clinical Indicators for Otolaryngology--Head and Neck Surgery are guidelines only. In no sense do they represent a standard of care. The applicability of an indicator for a procedure, and/or of the process or outcome criteria, must be determined by the responsible physician in light of all the circumstances presented by the individual patient. Adherence to these guidelines will not ensure successful treatment in every situation. The American Academy of Otolaryngology-Head and Neck Surgery, Inc. emphasizes that these clinical indicators should not be deemed inclusive of all proper treatment decisions or methods of care, nor exclusive of other treatment decisions or methods of care reasonably directed to obtaining the same results.
© 2000 American Academy of Otolaryngology-Head and Neck Surgery. One Prince Street, Alexandria, VA 22314.