Otolith repositioning maneuver
Jun 06, 2023
Source: Cainiu Health
Dr. Xu Gang
Introduction
The repositioning method for otolithiasis involves having the patient sit with their head turned to the right side, then slowly lie down while maintaining this position until dizziness subsides. Next, the head is turned to the left side and held until dizziness disappears. Then, both the head and torso are simultaneously rotated toward the healthy side and held until dizziness resolves. Finally, the patient is gently assisted into a sitting position. It is recommended that otolith repositioning procedures be performed at a正规 medical facility by a qualified physician.
Generally, for the repositioning treatment of benign paroxysmal positional vertigo (BPPV), the clinician manually rotates the patient's head to guide the dislodged otoliths back into the utricle or saccule of the vestibule. The specific procedure is as follows:
1. Place a pillow behind the patient before starting the procedure; when lying supine, position the prepared pillow under the shoulders.
2. Have the patient sit on the bed and turn their head 45° toward the affected side.
3. Quickly assist the patient to lie down, place the pillow under their shoulders, extend their neck, and position their head on the bed with the affected ear facing downward. Then tilt the head backward 45°, maintaining this position for at least 30 seconds or until dizziness subsides.
4. Slowly rotate the patient’s head back to the midline, then continue rotating it 45° toward the opposite side, holding this position for at least 30 seconds.
5. Next, simultaneously turn the head and trunk 90° toward the unaffected (healthy) side, maintaining this posture for at least 30 seconds.
6. Finally, rotate the head forward to face straight ahead, then slowly help the patient sit up into an upright position. The procedure is now complete.
Note: When rotating the patient’s head, apply appropriate force to avoid neck injury. It is recommended that BPPV repositioning maneuvers be performed at a正规 medical facility by a qualified healthcare professional.
