The most critical test for otolithiasis is the positional evocation test. There are two main types of positional evocation tests, one is the varus nystagmus evocation test and the other is the tumble test. The process of the position-evoked nystagmus test is: the patient sits on the examination bed with the eyes facing forward, the head is turned 45 degrees to the right, and quickly lies on his back, paying attention to keeping the head to the right at all times and protecting the neck; at this time the patient’s head is tilted back 20 degrees, showing an angle of 20 degrees with the horizontal plane. In the case of otoliths, the patient will feel dizzy and the eyes will sway back and forth when looking at things. This back and forth swaying of the eyes is called nystagmus and lasts for about 30 seconds, or longer for some patients and shorter for others. Observe until the dizziness disappears, then have the patient sit up quickly. In case of otolaryngitis, the patient will feel that the direction of looking at things has changed, which is completely different from what he/she felt just now, as he/she felt that he/she was turning counterclockwise, but after sitting up, it is exactly the opposite. We wait until this symptom is completely gone and the nystagmus is gone, and then do the following steps. Let the patient turn 45 degrees to the left side, then lie down again and observe whether he/she is dizzy or not; if he/she is dizzy, the doctor should observe the patient’s nystagmus; if he/she is not dizzy, sit up after a pause of 10-20 seconds. After sitting up, let the patient rest for about 30 seconds, and then we repeat the test just now. During the process, we should compare with the previous test to see if his dizziness and nystagmus have been reduced. If the dizziness and nystagmus are reduced, it is consistent with the vertical hemianopia, which is a diagnostic criterion to distinguish it from central positional nystagmus. The second test, called the rollover test, is described below. Some patients with cervical spondylosis simply twisting their heads may induce some neck discomfort, so we advocate rolling the whole body and head in a cylinder shape; first turn to the right, if dizziness occurs, nystagmus will appear, and the direction of nystagmus is usually downward (to the ground) or upward; observe until the nystagmus disappears and then lie flat with the eyes facing upward on the back, and observe the same performance just now. After the check, do a cylinder roll to the left side, turn the head 90 degrees, observe that no dizziness, nystagmus down, and then continue to lie on your back, the check is complete. Simply put, turn to the right side and lie flat, turn to the left side and lie flat again, and the rolling check is complete.