What is otolith disease?

Nov 26, 2025 Source: Cainiu Health

Dr. Lu Cheng

Introduction

In general, benign paroxysmal positional vertigo (BPPV) is a dizziness disorder caused by the dislodging of otoliths in the inner ear. It commonly occurs in middle-aged and elderly individuals, with sudden onset but a favorable treatment outcome. The otoliths in the inner ear are calcium carbonate crystals responsible for sensing gravity and linear acceleration, normally attached to the otolithic membrane. Otoliths may become dislodged due to factors such as head trauma, inner ear ischemia, aging, or inner ear diseases.

　　In general, otolith disease (benign paroxysmal positional vertigo, BPPV) is a type of dizziness caused by the dislodging of otoliths in the inner ear. It commonly occurs in middle-aged and elderly individuals, with sudden onset but generally good treatment outcomes. A detailed analysis is as follows:

　　Otoliths in the inner ear are calcium carbonate crystals responsible for sensing gravity and linear acceleration, normally attached to the otolithic membrane. When head trauma, inner ear ischemia, aging, or inner ear diseases cause these otoliths to become dislodged, they move with the lymphatic fluid and stimulate hair cells, leading to vestibular dysfunction. The hallmark symptom of this condition is positional vertigo—patients experience a sudden sensation of spinning when changing head positions, such as turning over in bed, sitting up, or bending the head forward. Episodes typically last from several seconds to tens of seconds and may be accompanied by nausea and nystagmus, but without tinnitus or hearing loss.

　　Diagnosis of otolith disease primarily relies on positional testing, during which doctors observe nystagmus by performing specific head maneuvers to confirm the diagnosis. Treatment mainly involves otolith repositioning procedures, using specialized manual techniques or instruments to guide the displaced otoliths back to their proper position. Most patients experience symptom relief after 1–2 repositioning sessions.

　　In daily life, it is important to avoid sudden, vigorous head movements and rapid standing. Adopting appropriate sleeping positions can also help reduce the risk of otoliths becoming dislodged again.

View All

How to manage dizziness after repositioning for otolithiasis

In general, dizziness after repositioning treatment for benign paroxysmal positional vertigo (BPPV) may be caused by residual otoliths stimulating the vestibular system, incomplete recovery of vestibular function, vestibular neuritis, Ménière's disease, insufficient cerebral blood supply, or other reasons. It is recommended to seek medical attention promptly, identify the underlying cause, and then improve symptoms under a doctor's guidance through general management, medication, or other treatments. In daily life, maintain a regular sleep schedule and avoid staying up late.

View Full Answer

What exactly is otolith disease?

Benign paroxysmal positional vertigo (BPPV), also known as otolith disorder, is a brief episode of dizziness caused by dislodged otoliths in the inner ear that stimulate hair cells in the semicircular canals. The dizziness typically lasts from several seconds to tens of seconds and is commonly triggered by changes in head position. If dizziness occurs frequently or is accompanied by nausea, vomiting, or hearing loss, prompt medical attention is recommended. Otoliths are calcium carbonate crystals located on the macula of the utricle in the inner ear.

View Full Answer

What are the consequences of not treating otolithiasis?

In general, benign paroxysmal positional vertigo (BPPV) is a vestibular disorder caused by dislodged otoliths. If left untreated, it can continuously impair quality of life, leading to frequent episodes of dizziness, impaired balance, increased risk of accidents, psychological problems, and other discomforts. BPPV is relatively easy to treat, and early intervention with canalith repositioning procedures is recommended once symptoms appear.

View Full Answer

How is otolith disease treated?

In general, the main treatment methods for benign paroxysmal positional vertigo (BPPV) include repositioning maneuvers, medication-assisted therapy, rehabilitation exercises, surgical intervention, and treatment of underlying causes. Additionally, during treatment, patients should avoid sudden head movements or quickly getting up to prevent the dislodgement of otoconia. If persistent dizziness occurs after repositioning, timely follow-up is necessary to adjust the treatment plan. Most patients can recover rapidly with proper management.