The cause of otolithiasis is unknown in about half of the patients, and may be related to hormonal changes, calcium metabolism disorders, etc. It is also common in sudden deafness and vestibular neuritis. The mechanism of this disease is unknown, currently recognized as the crural cap stone disease theory and tube stone disease theory. 1. Crestal cap lithiasis theory: otoliths from the ellipsoidal cystic spot detachment, adhesion to the posterior semicircular canal pot-belly and semicircular canal side of the crural cap, will increase its sensitivity to changes in gravity, and the appearance of the corresponding symptoms and signs. 2. Canal lithiasis theory: otoliths are dislodged from the ellipsoidal cystic spot, and the particles gather in the endolymph in the long arm of the semicircular canals near the pot-bellied area. With the movement of the head, the gravitational force caused by the particles drives the endolymphatic flow, which will stimulate the pot-bellied area and cause nystagmus and vertigo. Treatment of otolithiasis is based on repositioning of the otolith, and in some cases, the disease resolves spontaneously. The treatment of otolithosis should follow the doctor’s advice, do not self-medication, in order to avoid causing adverse consequences.