AMERKCAN ACADEMY OFOTOLARYNGOLOGY-HEAD AND NECK SURGERYOriginal Research-Otology and NeurotologyO U N DATI O NOtolaryngology-Head and Neck SurgeryGuideline Adherence to Benign2023.%L00(001-102023 American Academy ofParoxysmal Positional Vertigo TreatmentOtobryngology-Head and NeckSurgery Foundation.DOL:10.1002/ohn.315and Management in Primary Carehttp://otojournal.orgWILEYAmanda Del Risco,BA,Alex Cherches,BS,Sherri L.Smith,AuD,PhD2.3.4,and Kristal M.Riska,AuD,PhD23Abstractenign paroxysmal positional vertigo(BPPV)is theObjective.To determine adherence to the 2017 Americanmost common vestibular disorder encountered inAcademy of Otolaryngology-Head and Neck Surgery (AAO-primary care (PC).From 2013 to 2015,anHNS)guidelines for the management and treatment ofestimated 20.6 million adults presented to an ambulatorybenign paroxysmal positional vertigo (BPPV)in primary carevisit for dizziness,of which 9.2%received a diagnosis of(PC)and compare whether key recommendations differed byBPPV.2 BPPV has stereotypic symptomology of short-sex,race,or insurance status.duration vertigo that is triggered by a change in head and/orbody position.BPPV can have debilitating effects onStudy Design.Retrospective chart review.patients such as the increased risk of falls and impairedSetting.Twenty-six clinic locations within a single healthcaredaily activities.3 BPPV can be diagnosed via dinical historysystem.and bedside testing,with the gold standard diagnosticprocedure being the Dix-Hallpike maneuver.4.5 Patients canMethods.Charts of 458 patients diagnosed with BPPV in PChave complete resolution of symptoms by canalithbetween 2018 and 2022 were reviewed.Encounters whererepositioning maneuvers (CRMs)such as the modifiedthe diagnosis of BPPV was made were identified.From theEpley maneuver,and CRM is effective in resolving BPPVclinical encounter note,demographics,symptomatology,symptoms in 80%of cases with a single treatment.7.9management,and treatment were extracted.NonparametricGiven the stereotypical symptoms and effectiveanalyses were used to identify whether AAO-HNS guidelinesdiagnostic and treatment options,the Americandiffered regarding sex,race,or insurance status.Academy of Otolaryngology-Head and Neck SurgeryResults.Of 458 patients,249 (54.4%)did not receive a(AAO-HNS)issued clinical practice guidelines in 2008,diagnostic exam,and only 4 (0.9%)patients receivedwhich were updated in 2017 These guidelines offerimaging.Regarding treatment,only 51 (11.1%)receivedrecommendations (or key action statements [KASs))forthe Epley maneuver,with 263(57.4%)receiving vestibularboth specialists and nonspecialist providers with thesuppressant medication and 12.4%receiving a referral togoal of improving the diagnosis and management ofa specialist.In regard to sex,race,or insurance status,BPPV.KASs from the guidelines are summarizedthere was no significant difference in receiving a Dix-in Table I.Based on the evidence,a "strong recom-Hallpike diagnostic maneuver,Epley maneuver,vesti
