92538 Caloric vestibular test with recording, bilateral; monothermal (ie, one irrigation in each ear for a total of two irrigations)

Name of the Procedure:

Caloric Vestibular Test with Recording, Bilateral; Monothermal (ie, one irrigation in each ear for a total of two irrigations)

Summary

The caloric vestibular test is a diagnostic procedure that evaluates the function of the vestibular (balance) system in the inner ear by observing eye movements in response to temperature changes in the ear canal. This specific test involves one temperature irrigation in each ear, resulting in two irrigations in total.

Purpose

The test is primarily used to diagnose disorders of the vestibular system, which can affect balance and spatial orientation. It helps assess whether both ears are responding correctly to the temperature stimulus, aiding in diagnosing conditions like vestibular neuritis, Meniere's disease, and other balance disorders.

Indications

• Dizziness or vertigo
• Balance problems or unsteadiness
• Suspected vestibular dysfunction
• Unexplained falls
• Hearing loss accompanied by imbalance issues

Preparation

• Avoid alcohol and certain medications (e.g., sedatives, antivertigo drugs) for at least 24-48 hours before the test.
• Fasting is typically not required, but it's advisable to have a light meal to minimize nausea.

Procedure Description

1. The patient sits or lies in a reclining chair.
2. A small amount of warm or cold water (or air) is irrigated into the ear canal.
3. The patient's eye movements (nystagmus) are recorded using special goggles or electrodes.
4. The procedure is repeated for the other ear using the same temperature.
5. The clinician analyzes the eye movements to assess vestibular function.

No anesthesia or sedation is typically required.

Duration

The test usually takes about 30 to 45 minutes.

Setting

This procedure is commonly performed in an outpatient clinic or specialized vestibular laboratory.

Personnel

• Audiologist or vestibular specialist
• Assistant or technician to help with recording and monitoring

Risks and Complications

• Temporary dizziness or vertigo
• Nausea and vomiting
• Discomfort due to ear irrigation
• Rare risk of ear canal irritation or infection

Benefits

• Accurate diagnosis of vestibular disorders
• Helps in planning appropriate treatment or rehabilitation
• Provides a thorough assessment of inner ear function

Recovery

• Patients may feel dizzy or off-balance for a short period after the test.
• It is recommended to rest and avoid driving or operating heavy machinery until symptoms subside.
• Follow-up appointments may be scheduled to review results and discuss next steps.

Alternatives

• Vestibular Evoked Myogenic Potentials (VEMP)
• Videonystagmography (VNG)
• Rotary chair testing
• MRI or CT scans of the inner ear

Each alternative varies in terms of specificity, cost, and the type of information provided about vestibular function.

Patient Experience

• Patients may experience dizziness and mild discomfort during the test.
• Some nausea may occur but is usually short-lived.
• The clinician will provide instructions and support to ensure comfort and safety throughout the procedure.