As the pace of life accelerates and the pressure of life increases, there are more and more people with dizziness and vertigo, from children of a few years old to 80 or 90 years old who experience dizziness and vertigo. The idea that vascular nerve pressure in cervical spondylosis causes vertigo is so deeply rooted that even if he has high blood pressure or diabetes, he will think that cervical spondylosis causes vertigo, and there is no shortage of health care workers who ask for a cervical spine film or even carry a cervical spine film to consult about dizziness. But is vertigo really caused by cervical spondylosis? In fact, with the increasing understanding of dizziness and vertigo mechanisms, studies have found that dizziness induced or aggravated by turning the neck has multiple mechanisms of occurrence, the two most important of which are abnormal deep sensory afferents in the high neck and posterior circulation ischemia associated with compression of the vertebral basilar artery. In fact, the majority of cervical dizziness diagnoses lack reliable criteria and various pharmacological or surgical treatments lack scientific validation. Studies have reported that the majority of cervical dizziness diagnoses are eventually proven to be misdiagnosed. Therefore, the use of the concept of “cervical dizziness” to cover these two distinct conditions is inappropriate and should not continue to be used. As a doctor in a dizziness clinic, it is important to spread the common knowledge about dizziness. In the past, many doctors and patients attributed vertigo to “cervical spondylosis” and “Meniere’s disease”, but not all patients had satisfactory results. According to the latest Bárány Society Classification of Vestibular Disorders, the most common form of vertigo is benign paroxysmal positional vertigo (BPPV), also known as otoliths. Today, we will focus on otoliths. When it comes to otolithiasis, some people may ask if there is too much earwax, or they may even involuntarily touch their ear canal to see if it is blocked by earwax. In fact, “otolith” is a free-floating otolith fragment in the lymphatic fluid of the inner ear semicircular canal, which can induce vertigo attacks depending on its position. “Otoliths” is medically known as benign paroxysmal positional vertigo, which is a transient episodic vertigo with characteristic nystagmus caused by a paroxysmal change in head position. It is about twice as common in women as in men, and its prevalence increases gradually with age. “There are various types of otoliths, 85%-90% of which occur in the posterior semicircular canal, 5%-15% in the horizontal semicircular canal, and less commonly in the anterior semicircular canal. “The duration of otoliths varies, with some lasting months or years, and in severe cases, long-term loss of ability to work and care for oneself. Although the duration of vertigo symptoms during an attack of “otolith” is short, most of them do not last more than one minute, some patients may experience intense vomiting, sweating and other strong symptoms of autonomic dysfunction during the process of otolith displacement, so otolith repositioning treatment is preferred to relieve the symptoms in a short time. The treatment of otoliths is effective, but it needs to be operated by a specialist in vertigo clinic, so if you operate by yourself by watching the video, it may be counterproductive and aggravate the symptoms. At the same time, the treatment should be supplemented with medication, and if the treatment is ineffective for a long time, otolaryngology surgery can be considered. In the case of hemimelia (canal stone disease), it is relatively easy to reset, but there are also recurrences that require multiple resets; in the case of keratocystic cap stones, it is relatively difficult to reset and easy to recur. According to different types of otoliths, appropriate techniques can be used to reset them. After the otoliths are reset, there may be residual symptoms such as vertigo and dizziness, which may affect the patient’s daily life and may induce anxiety and depression in severe cases, so it is necessary to cooperate with medication and actively do vestibular rehabilitation. There are many diseases causing vertigo, such as central positional vertigo and other positional vertigo, posterior circulation ischemia, fourth ventricular tumor, multiple sclerosis, brainstem tumor, cervical vertigo, craniocerebral traumatic vertigo, phobic positional vertigo, etc., involving neurology, otorhinolaryngology, geriatrics, ophthalmology, psychiatry, etc. We cannot attribute all vertigo to otoliths and treat otolith reset as a panacea, nor can we misdiagnose otoliths as other diseases and treat them only with medication. For patients with vertigo, it is important to seek a specialist for identification to avoid misdiagnosis. It is necessary to take a detailed medical history, improve the cranial and cervical spine MRI, transcranial ultrasound multispectral (TCD), temporal bone CT and other examinations, and those with tinnitus, ear congestion and hearing loss must go to the ENT department for examination.