When the head moves, the otolith can cause an abnormal flow of lymphatic fluid in the semicircular canals, resulting in vertigo, but it is short-lived, often lasting less than a minute, especially if the head is turned in a certain direction, and is also known as benign paroxysmal postural vertigo.
The otolaryngologist will perform a type of otolith repositioning, in which the patient is asked to assume a certain position and then reorient his or her head to return the otolith to its original position, depending on the patient's individual situation.
For patients who are prone to dizziness, physical therapy can also be tried. Walking in a straight line with your head to the right or to the left, walking in the figure of eight, practicing walking backwards, or touching your heels to your toes can all help to restore your sense of balance.
Simple treatment for otolithiasis Take the supine head down position, turn 45° to the affected side, face up, head and torso to the opposite side, until the face down, the head position with the center line at 45 °, with the original supine position at 135 °, keep each head position 6-20 seconds, then sit up, the treatment process with a 50Hz vibrator on the affected side of the mastoid after. The above method is used consistently for 10--15 days, and will have some effect.
Manipulative restoration of otoliths Otoliths are painful, but now there is a very good treatment. The method does not require medication, the effect is strange, can be said to be immediate. This treatment is called "repositioning therapy". The doctor will give different repositioning treatments according to the different parts of the patient's body. By changing the position of the patient's head, the dislodged otolith will return to its original place, so that it can no longer stimulate the nerve endings, and naturally, the dizziness will be eliminated. Therefore, patients with vertigo symptoms should prefer neurology consultation to exclude other critical diseases that need urgent treatment, such as cerebral hemorrhage, cerebral infarction, brain tumor, etc. If the diagnosis of otolithiasis is confirmed, it can be treated with manual repositioning. However, due to the lack of understanding of this disease by many neurologists, it is very easy to be treated as "vertebrobasilar insufficiency" or "cervical spondylosis", and even if it is referred to the ENT department, it is easily misdiagnosed by young doctors in primary hospitals or large hospitals as "Meniere's disease". Some people run around multiple hospitals and spend tens of thousands of dollars before and after without obtaining a confirmed diagnosis. In fact, otolithiasis can account for 30-50% of daily outpatient vertigo patients, and the misdiagnosis rate is very high, the current medical community, especially neurologists should strengthen the education of otolithiasis.
Manipulation of otoliths is usually done once, but some patients require multiple repositionings. Outpatient treatment is usually sufficient, but some patients may need to be hospitalized for multiple repositionings. Vertigo may be induced during repositioning, and occasionally vomiting (with a family member) may occur, but this is usually short-lived and has no significant adverse effects. After successful repositioning, rest for half an hour before leaving and avoid driving. It is best to avoid lying down for three days after reset. It is recommended to sleep on a hard board bed and use a buckwheat skin pillow. Some hospitals have neurology and ear, nose and throat departments where this treatment is available. Patients from other countries who cannot be diagnosed locally or who cannot be correctly repositioned after diagnosis can also contact larger hospitals for treatment. Patients with severe cervical spondylosis, cervical spine trauma, cervical artery entrapment, or severe heart disease need to be treated with caution to prevent aggravation of the condition. It is important to note that although otolith manipulation seems simple, it must be operated by an experienced doctor, and patients should not reset themselves to avoid danger.
Otolithiasis itself cannot be prevented by medication. But some older patients with cerebrovascular disease may need to be given fluids at the same time. Some patients with anxiety, depression, insomnia, or vegetative dysfunction need to be treated with appropriate medications to prevent the recurrence of otolithiasis.