When drying clothes, a sudden look up, spinning dizzy, is "cervical spine is not good"? Lying in bed and turning over, vertigo for a few seconds, is "poor sleep"? Bent to tie shoelaces, suddenly dizzy and crooked, is the position change caused by "unstable blood pressure"? Desk work brain "black screen" moment, is the brain insufficient blood supply? These "dizzy moments" in life give people a lot of trouble.

In fact, it's probably related to the ear!

People who often have temporary vertigo should be careful of "otolithosis". For recurrent otoliths, as well as stubborn otoliths patients with symptoms of Meniere's disease such as deafness, tinnitus, and swelling in the ear, they should also be vigilant about the possibility of hearing loss or even deafness.

Deciphering otoliths: Watch for these red flags

What is "otolithosis"? In fact, it is "benign paroxysmal positional vertigo (BPPV)" is commonly known as, due to the "otolith" in the inner ear caused by the loss of temporary vertigo, so it is called "otolith".

The biggest feature of this disease is that the onset of vertigo is related to the change of head position, and the symptoms can appear or worsen with the change of body position.

Outpatient often encounter some "otoliths" patients, initially mistakenly thought that the cause of cervical spondylosis, poor sleep quality, blood pressure instability, etc., after multiple specialties, treatment effect is not good to learn that behind these danger signals are "otoliths" figure, and finally to the otoliths outpatient for help.

The main clinical manifestations of "otoliths" are when the head position or body position is changed (lying down, turning over in bed, lowering the head or looking up), there can be repeated episodes of brief dizziness, lasting from a few seconds to about 1 minute, and can be accompanied by nausea, vomiting, sweating and other symptoms.

"Otoliths" attack interval is often asymptomatic, there are also some patients after vertigo attack can appear dizziness and weakness, light weight and floating.

The "otolith" is a carbonate crystal of the inner ear, a normal structure of the inner ear. Under normal circumstances, the "otolith" is attached to the otolith membrane of the oval capsule, when some pathogenic factors cause the "otolith" to break away, these shed "otolith" movement to the semicircular canal, pulling the flow of lymphatic fluid in the semicircular canal, stimulating the hair cells of the semicircular canal, resulting in vertigo.

Multiple diseases

It is associated with "otoliths"

The occurrence of otoliths is related to many factors. It is often secondary to systemic underlying diseases, such as arteriosclerosis, hypertension, diabetes and other adverse factors can cause inner ear blood supply disorders, peripheral neuropathy.

The otolith membrane on the plaque of the oval capsule is thinnest due to malnutrition, and the "otolith" located on the otolith membrane falls off due to "unstable foundations" and is deposited in the semicircular canal.

osteoporosis

The incidence of osteoporosis is as high as 75%, while the normal control group is only 4%, which shows that osteoporosis may be inextricably linked with the occurrence of otoliths, and its pathogenic mechanism needs to be further studied.

Head trauma or ear surgery

The head is hit by an external force or the head accelerated movement immediately stopped, such as whiplash injury can cause this disease; In some middle ear and inner ear operations, such as stapedial surgery, the disease can be caused by local pressure or secondary loss of otolith when the stapedial foot plate is inserted into the vestibular window.

Other ear diseases

"I am not only dizzy, but also tinnitus, hearing is good and bad, before a doctor said I had Meniere's disease, and now diagnosed with otoliths, then what kind of disease did I have?" This is a question often asked in the vertigo clinic. This kind of disease and diagnosis and treatment experience does bring trouble to many people.

The reason is that "otoliths" can be secondary to the following kinds of ear diseases, in order of incidence: sudden deafness combined with vertigo, Meniere's disease, vestibular neuritis, viral labyrinthitis, middle ear mastoid infectious disease, peripheral lymphatic fistula and other diseases, are easy to cause the fall of otoliths particles agglutination induced by this disease.

The "otoliths" secondary to Meniere disease has the characteristics of both Meniere disease and "otoliths", the recurrence rate is high, and the treatment course is relatively long.

The effective rate can be as high as 80%

In general, the treatment effect of "otoliths" is very good, the preferred method of reduction, supplemented by drug treatment, often has immediate results - this is called "benign", and is legendary as "good treatment" reasons. However, about one to two percent of patients have recurrent episodes of vertigo, especially secondary to diabetes, Meniere's disease, and female menopause. Zeng Xiangli pointed out that for these stubborn "otoliths" patients, the cause is more complex.

Some people belong to the "otolith" too much loss at one time. For example, "otoliths" caused by trauma are easy to repeat, often due to severe trauma resulting in excessive loss of otoliths, a large range of dispersed in the semicircular canal, the otoliths are difficult to reset and excessive otoliths are not easy to absorb, so the disease can not be prolonged.

Some people have "otolith" that keeps falling out. The inner ear microcirculation disorder is not improved is also the cause of repeated disease, otoliths insufficient blood supply, malnutrition, and "unstable foundation" resulting in repeated loss of otoliths into the semicircular canal, and eventually "otoliths" repeated attacks.

Some people have "otoliths" and the residual symptoms persist. About 10% of patients continue to experience dizziness, weakness, lightness of the head, and floating after reduction. The reason for the persistence of this residual symptom may be related to the presence of trace otolith particles in the semicircular canal, the dysfunction of the oval sac and the mental disorders caused by long-term vertigo.

Most of the "otoliths" treatment effect is good, the effective rate of manual reduction treatment can be as high as 79.4%-92.7%, but there are still 12.8%-15.3% of patients need two or more reduction. If the symptoms are relieved after the first manual reduction treatment, but there is still a sense of spinning, instability, dizziness, and lightness of head, it is necessary to return to the doctor one week later to judge the treatment effect, and consider another reduction treatment, and supplemented by vestibular rehabilitation training.

Vestibular rehabilitation training is a physical training method to improve vestibular function and reduce the sequelae caused by vestibular injury through central adaptation and compensation mechanism. Vestibular rehabilitation training can be used as an adjoint treatment for otolith reduction in BPPV patients, for patients with poor reduction results and who still have dizziness or balance disturbance after reduction.