Patients with vertigo symptoms should first consult a neurologist to exclude other critical diseases that need urgent treatment, such as cerebral hemorrhage, cerebral infarction and brain tumor. If the diagnosis of otoliths is confirmed, the patient can receive “manual repositioning treatment”. This method does not require medication, is convenient and safe, and can be said to have an immediate effect. However, because many neurologists do not know enough about this disease, it is easily treated as “insufficient blood supply to the basilar artery” and “cervical spondylosis”. Some patients go to multiple hospitals and spend tens of thousands of dollars before and after they are diagnosed. In fact, otoliths can account for 30-50% of daily outpatients with vertigo, and the misdiagnosis rate is very high. The Department of Encephalopathy of Yancheng City Hospital has rich experience in the diagnosis and identification of the causes of vertigo, especially in the treatment of vertigo caused by otoliths with good therapeutic effect by applying manual repositioning, which is well received by patients. At present, our department has started the treatment of otoliths. Otoliths, also known as benign episodic positional vertigo, are brief episodes of vertigo induced by head movements or body posture. It is more common clinically. It is mostly seen in 40-60 years old, and more women than men. When the otoliths are dislodged by some causative factor, the dislodged otoliths move in the fluid called endolymph in the inner ear and this movement stimulates the nerves that feel the change in the body’s position, causing the person to feel a spinning sensation, usually for a short period of time, from a few seconds to tens of seconds, usually no more than 1 minute, with periodic episodes or remissions of varying duration. Why do otoliths fall out? Most of them are of unknown origin and the causes that can be identified include middle ear surgery, inflammation of the middle ear, labyrinthitis, senile degeneration of the inner ear vestibule and head trauma. This type of vertigo has several characteristics, including: 1. a change in head posture followed by an incubation period of about a few seconds to a dozen seconds, followed by a sudden onset of vertigo; 2. a gradual decrease in symptoms when repeatedly induced; and 3. association with specific head movements and postures. The most effective treatment for benign paroxysmal postural vertigo is “resetting by manipulation”. Most patients with otoliths can be cured after 1-2 times of resetting by manipulation, and a week after resetting by manipulation, the symptoms no longer appear. The otolith manipulation is a process in which the physician adjusts the posture of the patient’s head and neck to allow the otolith to move to a position that does not irritate the nerves, and the entire process takes only a few minutes. Patients who have undergone otolith manipulation should not turn their head rapidly for the next two to three days and should sleep with their head elevated. The otolith repositioning procedure allows the patient to heal earlier than traditional medication-only treatment. Otoliths are the most common of the various diseases that cause vertigo and have a good prognosis if they are diagnosed and treated early. Otolith manipulation is a special treatment method that is safe, effective, simple and economical. It allows most patients to quickly say goodbye to vertigo.