Otoliths are also known as “benign paroxysmal positional vertigo”, so why do people get otoliths? And what causes it? During the evolution of human beings, the inner ear has differentiated into two sacs, namely the bulb and the ellipsoidal sac, which are called “otoliths” because of their structure. Balance. Inside the otolithic apparatus, there is an area of sensory cells – the capsule – and a layer of otolithic membrane on the surface of the capsule, to which many calcium carbonate-like crystals are adhered, called otoliths. Under normal circumstances, the otoliths are attached to the otolith membrane. When some pathogenic factors cause the otoliths to detach, these detached otoliths will swim in the fluid called endolymph in the inner ear, and may enter the semicircular canals, where no otoliths exist, and settle down. The duration of vertigo is generally short, often less than a minute, compared to the majority of canal stones, and in a small number of cristae stones the duration of vertigo is often more than a few minutes. The appearance of this symptom is often associated with a change in position, so it is now paroxysmal, which is called “benign paroxysmal positional vertigo”. The clinical manifestations of otoliths have 5 characteristics: 1. latency: vertigo appears only after 1 to 4 seconds after the change of head position; 2. rotational: vertigo has an obvious sense of rotation, and the patient can see objects rotating or close his eyes and feel his own rotation; 3. transient: vertigo stops spontaneously in less than 1 minute; 4. transitional: vertigo can be induced again when the head returns to its original position; 5. fatigue: vertigo symptoms gradually decrease after several changes of head position. The symptoms of vertigo can be gradually reduced after several changes of head position. Treatment of otoliths: 1. Application of vestibular inhibitors, such as cerebrolysin and finagan. 2. 2.Secondary otoliths should be treated by etiology. 3.Position therapy. 4.Tubular stone release method. 5.Canal stone reset method. 6.Epley repositioning method: This method usually requires only one time and has good simple effect. 7.CH ~ BPPV otolith repositioning method. The efficiency of the above treatments varies, and there is also a certain recurrence rate. If the above treatments are ineffective and affect the quality of life and work, surgical treatment can be considered.