Although benign paroxysmal positional vertigo is a growing concern, there are still some patients who are unfamiliar with it when they hear about it, but it is actually the most prevalent vertigo disorder that has been unknown in the past. Data from France show that about 34% of vertigo patients have benign paroxysmal positional vertigo, and surveys in the United States show that about 50% of older adults over the age of 70 have had at least one episode of otolaryngitis. The high prevalence of the disease is evident in the fact that at least 50% of patients in ENT vertigo clinics are suffering from this disease. If you wake up and sit up in the morning as well as when you lie down in bed at night, or when you turn over to one side in the middle of the night, you suddenly experience a violent spinning in the sky, often accompanied by nausea and vomiting. In severe cases, even the mere act of raising or lowering the head can induce vertigo. Many such cases are diagnosed as cervical spondylosis. In fact, if such a symptom occurs, nine times out of ten it is caused by an ear problem, and this ear disease is called benign paroxysmal positional vertigo, also known as otoliths. Why can ear disease cause vertigo? It turns out that the inner ear, the deepest part of our ear, is responsible not only for hearing but also for balance. The inner ear senses changes in the body’s position and movement, and then sends this information to the brain. If there is a problem with the inner ear and the wrong information is sent to the brain, the patient will feel spinning or wobbling, which is also known as vertigo. In the inner ear, on both the ellipsoidal and balloon sacs, there is a structure that senses linear acceleration, called the saccule. It has an otolithic membrane on its surface with many calcium carbonate crystals, which we call otoliths. In some cases, such as senile aging, inadequate blood supply to the inner ear, vagal concussion, otitis media, ear surgery and blockage of the anterior branch of the vestibular artery, among many other causes, can cause the otolith to be dislodged as a result of metamorphosis of the oval sac’s capsule. In this case, if the patient sits up, lies down or turns his head, the movement of the otolith will stimulate the jugular crest and produce a violent spinning of the sky. Mild head trauma can dislodge the otoliths from the gelatinous surface of the ellipsoidal sac, including head bruises, roller coaster rides or high-speed rotating sports, braking sharply on a bicycle, head banging during sports, etc. Once these particles or fragments enter the semicircular canal, vertigo will occur. In addition to the dizziness caused by head hematoma and contusion, the possibility of benign paroxysmal positional vertigo must be considered once the dizziness is caused by fall or bruise. II. Treatment The doctor can determine the disease as well as the semicircular canal into which the otolith is dislodged based on the vertigo induced by the change of position and the rotational rotation of the patient’s eyes. The main method of treatment is manual repositioning. Based on the alignment of the semicircular canal, a cephalic rotation method was clinically designed with the aim of curing the disease by rotating the otolith out of the semicircular canal and dropping it back into the elliptical sac. The patient has an immediate recurrence and can be reset several times.