How to check and confirm otolithiasis

Written by Xu Qing Tian
Otolaryngology
Updated on May 24, 2025
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The examination for otolithiasis is usually based on the patient's chief complaint symptoms, as well as by performing positional changes to diagnose. The onset of otolithiasis is caused by the detachment of the otoliths from the utricular macula, falling into the horizontal or superior semicircular canals, thereby triggering vestibular stimulation symptoms. Patients may experience vertigo, nausea, vomiting, and cold sweats among other related symptoms. Patients with otolithiasis usually have a short duration of illness, with the vertigo disappearing within 30 seconds to two minutes. After diagnosing otolithiasis, manual repositioning is typically required to move the otoliths from the semicircular canals back to the normal utricular macula position, thereby improving the patient's symptoms such as vertigo.

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Written by Xu Qing Tian
Otolaryngology
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The difference between otolithiasis and Ménière's disease

The main difference between BPPV (Benign Paroxysmal Positional Vertigo) and Meniere's Disease lies in their symptoms and causes. BPPV primarily manifests as episodes of dizziness due to dislodged otoconia moving into the semicircular canals, leading to vestibular irritation. On the other hand, Meniere's Disease presents a group of symptoms including vertigo, fluctuating hearing loss, and tinnitus, thought to be caused by fluid accumulation in the labyrinth, triggering labyrinthine irritation.

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Written by Li Rui
Otolaryngology
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What should be paid attention to in daily life with otolithiasis?

Patients with ear stone disease should pay attention to the following aspects in daily life: The first is to avoid staying up late and excessive fatigue; The second is not to look down at the phone or computer for long periods to avoid cervical spine disease; The third is to avoid external impacts to the head or substantial external pressure, as these could potentially cause a recurrence of ear stone disease; The fourth, even after treatment has ended, regular follow-ups are essential to monitor any changes in the condition; The fifth suggestion is to undergo an MRI of the head to check for any intracranial abnormalities. Overall, most patients with ear stone disease respond well to timely treatment.

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Written by Li Rui
Otolaryngology
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Is otolithiasis prone to recurrence?

Ear stone disease, also known as benign paroxysmal positional vertigo, is a relatively common otolaryngological condition that tends to recur. According to the current treatment protocols, the first consideration is manual repositioning treatment. After standardized manual repositioning treatment, most patients can gradually recover and alleviate their symptoms. Some patients respond very well and can recover immediately after manual repositioning, but there is a possibility of recurrence. Therefore, regular otolaryngological check-ups are necessary, and the head must not be subjected to external impacts. In the short term, avoid vigorous exercise and monitor the recovery of the condition.

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Written by Li Rui
Otolaryngology
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Is the examination for otolithiasis painful?

Patients with vestibular disorders may experience some discomfort during examination, primarily manifesting as recurrent dizziness. Some patients may also experience nausea and vomiting. However, examination can determine the specific location of the affected semicircular canal. Once the location is identified, targeted manual repositioning treatment can be administered. The preferred treatment currently is manual repositioning, which generally has an ideal therapeutic effect. Most patients show significant improvement after manual repositioning treatment, but there might be recurrent episodes of the condition. In case of recurrence, it is necessary to seek medical advice again and undergo repositioning treatment.

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Written by Li Rui
Otolaryngology
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For vertigo, register at the Department of ENT (Ear, Nose, and Throat).

Otolithiasis, also known as benign paroxysmal positional vertigo, is primarily caused by abnormalities in the vestibular semicircular canals. It is a common condition with a relatively high incidence in clinical settings. It is generally recommended to consult either an otolaryngology or neurology department, as both are equipped to handle this condition. There are several treatment methods available, with manual repositioning treatment being the preferred first choice. Most patients can recover after undergoing manual repositioning treatment. For a small portion of patients who do not respond well to manual repositioning, machine repositioning chairs can be considered, in conjunction with pharmacological treatment. However, for a very small group of patients who do not respond to conservative treatment, surgical treatment may need to be considered.