Otoliths are clinically known as benign paroxysmal positional vertigo, which refers to a brief paroxysmal attack of vertigo and nystagmus when the head moves rapidly to a specific head position. The otolith repositioning is the preferred treatment for this condition, and by “repositioning” I mean transferring the floating otolith out of the semicircular canal. Although otolith repositioning is the preferred treatment, it is also not a curative treatment, and some patients may have residual dizziness, i.e. vertigo, for the following possible reasons: 1. The reason for otolith repositioning itself: the otolith is one of the structures involved in controlling the body’s balance, and can cause vertigo when the otolith is displaced. When the otolith is reset, it will inevitably displace the otolith, and some patients may experience severe vertigo after the reset, therefore, patients are usually asked to sit still for half an hour after the reset. In addition, after the otolith enters the ellipsoidal sac from the semicircular canal, that is, after the so-called “reset”, it still stimulates the balance receptors in the ellipsoidal sac, which is also the reason for dizziness and unstable shaking after the reset. 2. Vestibular function is not fully restored: vestibular function can control the body’s balance. In some cases of otoliths, the vestibular function of the patient is impaired, and although simple otolith restoration can improve the symptoms, it is necessary to take drugs to restore the vestibular function at the same time after restoration. 3. Recurrence of otoliths: Otoliths are a disease that is prone to recurrence, especially in the short term after reset, because the otoliths are still floating in the inner ear labyrinth and may enter the semicircular canal again, thus causing symptoms. Only when the dislodged otolith adheres to the wall of the oval sac or completely disintegrates does it eventually stop recurring. 4. Caused by other diseases: otoliths can be secondary to vestibular neuritis, Meniere’s disease, sudden deafness, viral labyrinthitis, migraine, head trauma, after middle or inner ear surgery, after cochlear implantation, otosclerosis, inner ear malformation, chronic middle ear mastoiditis, ototoxic drugs, etc. If the above diseases are not resolved, vertigo can also remain. In summary, if dizziness still exists after otolith repositioning treatment for otoliths, medications such as betahistine can be taken to relieve the symptoms. If the symptoms are not relieved or worsen, re-dislodgement of the otolith cannot be ruled out and prompt medical attention is required.