I just returned from a visit to the best otolaryngology hospital in the United States, during which I focused on their treatment of vertigo patients, and I should say that I still found many differences from those in China. In foreign countries, a patient with vertigo takes at least 20 minutes to be seen, and the doctor will ask the patient’s medical history carefully, catch the clues from the patient’s statement, and then conduct a targeted specialized examination, and usually will not let the patient have too many auxiliary examinations for the first time. In China, patients often complain that the doctor’s visit is haphazard, often spending several days running around to auxiliary departments, CT, MRI, cerebral angiography, cerebral hemogram, vestibular function tests, auditory evoked potential tests, etc., and finally come back to the doctor when 80% of these test results will not find abnormalities, so the doctor will tell the patient that there is no major problem, prescribe some drugs to go home and slowly recuperate The other day, a good friend’s father had a heart attack. Two days ago, a good friend’s father had been suffering from vertigo for 9 months, during which he had a hard time seeing a doctor, almost all the famous experts in major hospitals in Beijing, but there was no clear conclusion so far, and what is more incredible is that the experts in several major hospitals did not even examine the ear canal, and finished seeing the patient in 3 minutes. It can be seen how busy the specialists in some big hospitals in China are, there are really too many vertigo patients and they are really too busy. The popularity of vertigo is a matter of these years, unlike otolaryngologists, most of whom have been specializing in otolaryngology for a long time, and their thinking may be more or less limited. As an otolaryngologist, I have accumulated my personal experience in the treatment of vertigo in otolaryngology in recent years, in addition to the scalpel in my own hands. There is no doubt that conservative treatment is preferred for patients with vertigo, rather than going to the operating table when they come, but if the treatment result is unsatisfactory, how long should surgery be recommended, what kind of surgical treatment should be performed and the order of various surgical treatments is a great learning curve. However, there are a few patients who do not want surgery but actively request it, which makes doctors helpless. During our study abroad, we found that foreign countries may be more proactive than us in choosing surgical treatment because they have experience in thousands of surgical cases and are very confident about the prospect of treatment, so we can say that we have a good idea. Therefore, for the treatment of vertigo patients we surgeons should not forget the powerful tool in our hands – the scalpel, but of course the scale is crucial. So where should vertigo patients go and how to choose the right doctor for their condition? If you find an experienced vertigo specialist, he can make a diagnosis of whether it is an otologic disease on the one hand, and if you exclude otologic diseases on the other hand, he can also give advice on the next department you should see. Because besides otologic diseases, there are also neurologic diseases, orthopedic diseases, and ophthalmologic diseases that can cause vertigo, but in general, it is true that the percentage is much lower than that of otologic diseases. However, it is important to emphasize the importance of history-tracking and specialized otologic examinations during the consultation. If the doctor writes a long list of tests without asking a few questions, it is advisable to change the doctor. Many patients suspect that their vertigo is caused by cervical spondylosis, and this notion is well established, but in fact, according to recent research findings, the percentage of vertigo caused by cervical spondylosis is very small, and it is questionable whether it is necessary to take a cervical spine film to rule out cervical spondylosis in every patient. A very confusing complaint is the spinning of the sky when turning the head, which makes patients and doctors more suspicious of cervical spondylosis, but in fact, most of these cases are caused by otoliths, because according to statistics, vertigo caused by otoliths has accounted for 20% of peripheral vertigo patients, and the treatment of otoliths can be miraculously effective with just a few minutes of manipulation to reset. This requires doctors to be fully aware of and sensitive to otoliths, otherwise it will be a great pain in the neck, and patients will end up running to many departments and hospitals without relief. I have come across many examples of this kind of patients. Sometimes the patient has no choice but to look it up on the Internet, and when they don’t, they realize that they probably have otoliths and find an otolaryngologist. This is a warning to many of our doctors that if our knowledge is not updated in time, it will cause delay in diagnosis of the disease, which will harm people and themselves. In recent years, it should be said that the treatment level of vertigo has made great progress in China, but it is still not satisfactory because there are too many patients with vertigo and too many diseases, and too few doctors really know how to diagnose and treat vertigo, and most of the time, patients still run to different hospitals and different doctors to get the correct diagnosis and treatment, which makes people feel painfully anxious. And the trouble that vertigo brings to patients is unimaginable to normal people. The author once had a brief experience of dizziness, which I remember very well, and it is really hard to describe and painful. Therefore, we must pay enough attention to vertigo, and while establishing a specialized vertigo clinic, we should pay more attention to improving the knowledge structure of doctors and learning the latest treatment methods, so that we can eventually establish a truly specialized vertigo treatment team, converge with the advanced foreign level as soon as possible, and pay attention to the collection and summary of cases in order to better serve patients.