Ms. Zhang, a 64-year-old citizen, woke up in the middle of the night and suddenly became dizzy, not daring to open her eyes, and became vertiginous when her head was turned. After detailed examination, the cause of vertigo was determined to be “otolithiasis”. After otolith repositioning treatment, Ms. Zhang felt that her symptoms were relieved after 3 days, and then she was prescribed Chinese herbal medicine to treat the symptoms. Patients with otoliths are very common in clinical practice, but due to the lack of understanding of the disease by many doctors, they are easily treated as cervical spondylosis and cerebral insufficiency, and the misdiagnosis rate is very high. The scientific name of otolaryngitis is “benign paroxysmal positional vertigo”, which is a transient vertigo and nystagmus that occurs when the head moves to a specific position. In general, the vertigo is noticeable when a person turns over, gets up, lies down, or lowers or tilts his or her head. This “vertigo” is not life-threatening, like a brain attack or brain hemorrhage. It occurs only when the body position changes, so it is also called “positional vertigo”, a sensation of spinning and falling, and each time the vertigo lasts for less than a minute, it is relieved. The otoliths occur in the middle ear’s semicircular canal, and the ellipsoidal and balloon sacs connected to the semicircular canal have a gelatinous membrane on the surface, and the calcium carbonate particles on the surface of the gelatinous membrane are called otoliths. When the otolith is dislodged, it will fall into the semicircular canal. When the body position changes, the otolith particles in the semicircular canal will move from top to bottom with the body position, causing the lymphatic fluid in the semicircular canal to vibrate during the movement, stimulating the hair cells in the semicircular canal and transmitting this vibration to the brainstem and cerebellum, causing a feeling of vertigo, and also causing sympathetic excitation, causing nausea, vomiting, panic attacks, and other feelings. Some people think of otoliths as “ear wax”, but this is not true. The earwax we usually refer to as “cerumen” is secreted in the external ear canal and can be cleaned out when pulling out the ear. It can only be treated by means of otolith restoration. The pathogenesis of otoliths remains unclear; it may be an isolated idiopathic symptom or it may be triggered by certain disease factors. For example, in otolithiasis, the otoliths on the otolith membrane are dislodged and deposited in the semicircular canal when the vagus is aging or degenerating; in the inner ear, the otoliths are dislodged and deposited in the semicircular canal when the otoliths are dislodged and deposited in the semicircular canal due to insufficient blood supply to the inner ear caused by atherosclerosis, hypertension, diabetes mellitus, and other factors, and the glial membrane on the capsule of the ellipsoid bursa is thinned due to nutritional disorders. Ear infections can develop due to agglutination of cellular debris or bilateral vestibular asymmetry. Trauma to the head can also cause otoliths. When a person’s head is struck by an external force, the otolith can be dislodged from its original position and roll down into the semicircular canal, stimulating the hair cells as the head moves and causing severe vertigo. Do not panic after the occurrence of otoliths, because otoliths are a self-limiting disease with a relatively good prognosis and most patients are cured. However, it should be distinguished from brainstem or cerebellar infarction, hemorrhage, pontocerebellar horn tumor, and Meniere’s syndrome. Patients should pay attention to whether there are symptoms such as headache, crooked mouth, unfavorable speech, choking on water, numbness and weakness of limbs after the onset of the disease. If there are no such symptoms, the possibility of stroke is unlikely, but it is impossible to identify accurately as an ordinary person, so it is still necessary to go to the hospital immediately to rule out the possibility of other causes of vertigo. The most important treatment for otoliths is the otolith repositioning method. The repositioning method is different for different hemianopia otoliths, and the commonly used techniques are Epley’s maneuver or Barbecue’s tumbling method, the former is mainly for otoliths in the posterior hemianopia and the latter is mainly for otoliths in the horizontal hemianopia. The ultimate goal of repositioning is to return the otoliths located in the hemianopia to the oval sac, and the patient’s vertigo symptoms will be relieved.