What exactly is otolith disease?

Benign paroxysmal positional vertigo (BPPV), commonly known as otolith displacement, is a brief episode of dizziness caused by dislodged calcium crystals in the inner ear stimulating hair cells within the semicircular canals. Episodes typically last from several seconds to tens of seconds and are often 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. Normally, they adhere to the surface of the macula. However, due to head trauma, aging, or ear disorders, these crystals may become dislodged and migrate into the semicircular canals. When the head changes position, the displaced otoliths move with the lymphatic fluid, stimulating hair cells and causing transient vertigo. This condition does not involve tinnitus, ear fullness, or other ear discomforts.

Treatment primarily involves manual repositioning maneuvers, which use specific head movements to guide the displaced otoliths back into the utricle. Most patients experience significant symptom relief after 1–2 repositioning sessions. A small number of recurrent cases may require multiple treatments, and combining these with vestibular rehabilitation exercises can help consolidate therapeutic effects. In general, medication or surgery is not required.

To prevent episodes, avoid rapid head turning, sudden bending over, or quickly rising when lying supine. Move slowly when getting up or lying down, protect against head injuries, maintain regular sleep patterns to preserve inner ear function, and immediately stop any activity and hold onto a stable object during an episode to prevent falls and injury.