Video of rapid manual repositioning for otolithiasis

In clinical practice, specific maneuvers can be used to reposition the otoliths and treat benign paroxysmal positional vertigo (BPPV). Otolith repositioning must be performed by trained professionals. The detailed steps are as follows:

1. The patient sits upright on the bed, and the doctor stands behind the patient, supporting the patient's head while rotating it 45 degrees toward the affected side.

2. Instruct the patient to lie down quickly, allowing the head to extend over the edge of the bed so that it hangs freely. The doctor then rotates the patient’s head further to position the affected ear downward, maintaining this posture for at least half a minute.

3. After the sensation of vertigo subsides, gradually turn the head back to the midline, then continue turning it 45 degrees toward the opposite side, holding this position for at least half a minute.

4. Simultaneously rotate both the head and body 90 degrees toward the healthy side, positioning the head at a 45-degree angle relative to the ground, facilitating the return of the otoliths into the utricle. Maintain this posture for at least half a minute.

Patients are advised to undergo this procedure at a professional medical facility under a physician's guidance. During repositioning, care should be taken not to apply excessive force to avoid worsening symptoms.