Many patients have experienced sudden, violent spinning in the morning when they get up and sit up, or at night when they lie down, or in the middle of the night when they turn over to one side, and sometimes vertigo can be triggered even by the mere act of raising or lowering the head. If you have such symptoms, it is likely that they are caused by ear problems, which are called “otoliths” or “benign paroxysmal positional vertigo” in medical terminology. Why can ear disease cause vertigo? It is caused by a dislodged otolith, when a change in the position of the ear causes a problem with the balance of the inner ear, resulting in vertigo. The balance function of a normal person is composed of the visual system, proprioceptors and vestibular receptors, and the vestibular receptors inside the ear are the main organs responsible for balance. The inner ear senses the position of the body as well as changes in movement, and then sends this information to the brain. If there is a problem and the wrong information is sent to the brain, the patient will feel spinning around, which is also known as vertigo. There are three main medical theories as to why the “otolith shift” occurs, which are simply explained by head trauma, viral infection, and impaired inner ear circulation. Otolith repositioning can be used to treat otoliths, and good results can be obtained with otolith repositioning therapy. Otolith repositioning therapy actually involves the patient, with the assistance of a physician, lying on his or her back and suspending the head and then turning it in a different direction, allowing the otolith to return to its original position after several repetitions, and with relatively obvious results. Since there are no clinical tests that can confirm the diagnosis of otoliths, most doctors rely on the patient’s symptoms, medical history and clinical examination to make a diagnosis. Repositioning therapy also does not always result in complete eradication of otoliths. Although most patients are completely cured after one to two treatments, some patients may experience a recurrence after months or years of healing, but even so, treatment with the same method can be repeated as long as it is repeated. Do not misdiagnose vertigo caused by displaced otoliths as cervical spondylosis. Since cervical spondylosis is becoming more and more common in modern society, many patients and even some doctors do not know much about otoliths and once vertigo occurs, the first thing that comes to mind is cervical spondylosis. When some problems are found after the cervical spine photo examination, it is easy to simply equate this kind of vertigo with cervical spine disease. Whether vertigo is caused by otoliths or cervical spondylosis cannot be concluded simply by photos, even if the cervical spine photos reveal some problems. Ultimately, it is necessary to make a correct diagnosis based on the doctor’s professional knowledge and clinical experience, and then through questioning the medical history, careful physical examination, reference to auxiliary examinations, and finally through inductive analysis, to distinguish what causes vertigo. Of course, besides otolithiasis and cervical spondylosis, there are also other diseases that can cause vertigo, which should be identified and excluded, such as hypertension, cerebral infarction, vascular sclerosis plaque formation, depression, anxiety, etc.