Otolithiasis, the standard clinical name for benign paroxysmal positioonal vertigo (BPPV). It is a transient, paroxysmal vertigo with horizontal or rotational nystagmus that is triggered by a rapid movement of the head position to a specific position. Most patients experience vertigo as a spinning sensation when they get up, fall backwards into bed, or turn over in a certain direction in bed, accompanied by nausea and vomiting. The episodes of vertigo are brief, lasting a few seconds or tens of seconds, and rarely last more than a minute. The incidence of otoliths is about 64/10,000, and it is the most common kind of vertigo, especially in middle-aged and elderly women who are most likely to have attacks. However, due to the popularity and widespread use of computers, people who work at desk jobs for long periods of time have also become a risk group, so otoliths are becoming younger and younger, but the cause is unknown. Which part of the body is the problem of otoliths? It turns out that the inner ear, which is hidden inside the temporal bone of the human body, is an organ for maintaining balance in addition to its auditory function. The receptors for linear acceleration and gravity are the ellipsoidal and balloon sacs in the vestibule, each of which has a capsule with calcium carbonate crystals that feel changes in gravity and are shaped like stones, called otoliths. The receptors for angular acceleration are the three semicircular canals, which are angled at 90° to each other and all open in the vestibule. Due to head trauma or local structural degeneration, the otoliths are dislodged from their original vestibular position and fall into the semicircular canals. This causes vertigo when the head position changes. The most important clinical manifestations of otoliths are: 1. paroxysmal transient vertigo induced by specific head position changes. 2. 2. The duration of each episode is usually less than 1 minute. 3. There is a certain latency period, and symptoms usually appear only after a few seconds of head position change. 4. It is adaptive or easily fatigable, i.e., the degree of vertigo will be reduced after repeatedly changing to the stimulation position. 5. It is self-healing, and the condition may resolve on its own within weeks or months, but in a few cases, it may last for several years. Through the medical history described by the patient, the doctor can basically make the initial judgment of otoliths, but the final diagnosis and clarification of the location of the otoliths will have to undergo a rigorous examination. The location of the dislodged otolith varies and can exhibit nystagmus in different directions, which is the basis for otolith localization. For example, in the case of a horizontal hemiocapsule otolith, vertigo often occurs when turning to the left or right, but is more severe when turning to one of the sides; an examination will reveal horizontal nystagmus when the patient changes position, with the intensity of nystagmus being greater when turning to one side and less intense when turning to the other side. In contrast, posterior semicircular otoliths usually present as vertigo when lying back and when sitting up, and the examination will reveal clockwise or counterclockwise torsional nystagmus. Benign paroxysmal positional vertigo is not a life-threatening disease in itself. However, due to the pronounced vertigo, sometimes accompanied by severe nausea and vomiting, patients may be more fearful. Dislodged otoliths are in different locations and need to be reset using different techniques. Therefore, patients who are ill should visit a doctor who is experienced and specialized in treating vertigo. An experienced doctor can make a correct judgment through examination. The correct manipulation is chosen to make the treatment easy and effective. For doctors without formal training, wrong methods and rough handling may lead to ectopic otoliths and aggravation of vertigo in patients. Traditional manipulation inspection and resetting is mainly done by the doctor’s naked eye or by giving the patient a magnifying glass to observe the direction of the nystagmus and the effect of resetting, which has a certain degree of error. Moreover, the patient’s neck is twisted during the manipulation, which may cause cervical vertigo. Some of the symptoms of cervical vertigo are very similar to those of otolith examination, which can lead to misdiagnosis. The TRV swivel chair designed for otolith examination and repositioning is one of the most advanced instruments for otolith diagnosis and treatment in the world. The TRV swivel chair integrates the patient and the swivel chair into a single unit, allowing the patient’s head to be placed in the desired position with a high degree of precision and simplicity through the swivel axis. It can precisely locate the otolith of the hemimelia and reset the otolith according to the lesion area, thus making the diagnosis and treatment more accurate, safe and effective. The principle of otolith repositioning in this swivel chair is to use the gravity acceleration of rotating in the exact direction and then stopping sharply to reposition the otolith, especially the tiny otoliths, with good repositioning effect. Compared with the traditional manual reset, this instrument reduces the imprecision of the manual reset and increases the efficiency of the reset. Patients can basically recover completely after 1-2 resetting treatments. After the treatment, patients are asked to rest for a week, and it is advisable to get up and back up slowly; after two weeks, they can carry out fully normal activities. Some studies have shown that otolith dislodgement may be related to calcium deficiency. Therefore, patients with frequent episodes of otoliths are advised to take some calcium supplements in moderation.