How to reposition displaced otoliths
Oct 27, 2022
Source: Cainiu Health
Dr. Xu Gang
Introduction
For dislodged otoliths, the physician must first turn the patient's head 45 degrees to the side, then rotate the body so that the affected ear faces downward. This position should be maintained for at least 30 seconds, or one minute after the sensation of vertigo disappears. The same procedure is performed on the other side. Finally, the head and torso are simultaneously turned 90 degrees toward the healthy side, with the head angled at 45 degrees relative to the ground, which helps guide the otolith back into the utricle.
Otolith displacement generally refers to the detachment of otoliths from their original position into the semicircular canals. Patients may undergo manual repositioning treatment under a doctor's guidance, either by themselves following medical advice or at a hospital. The specific steps are as follows:
1. First, have the patient sit on the bed while the doctor stands behind them, supporting the patient’s head and turning it 45 degrees toward the affected side.
2. Quickly lay the patient down, extending their head backward so it is suspended in the air, and rotate it such that the affected ear faces downward. This position should be maintained for at least 30 seconds, or one minute after any sensation of vertigo disappears.
3. After the dizziness subsides, gradually turn the head back to the midline, then continue rotating it 45 degrees toward the opposite side. Maintain this head position for at least 30 seconds, or one minute after any rotational sensation has ceased.
4. Simultaneously rotate the head and body 90 degrees toward the healthy side, positioning the head at a 45-degree angle relative to the ground. This helps guide the displaced otoliths back into the utricle (specifically, the elliptical sac). Maintain this posture for at least 30 seconds, or about one minute after the vertigo resolves.
Precautions: Performing these maneuvers correctly can successfully reposition the otoliths, thereby relieving symptoms such as dizziness, nausea, and vomiting. It is recommended that patients seek treatment at a professional medical facility and perform the procedure under a physician's supervision. During repositioning, avoid excessive force to prevent worsening of symptoms.
