Canalith Repositioning Procedure
Overview
Benign paroxysmal positional vertigo (BPPV) creates sudden episodes of dizziness and spinning, especially when a person changes the position of their head. The root cause of BPPV lies in the inner ear, mainly when tiny particles called canaliths, also known as otoconia, break away from their original area and travel into the semicircular canals.
The canalith repositioning procedure guides these canaliths back to a location in the inner ear where they no longer affect balance. During the procedure, healthcare providers use a series of gentle head movements to shift the otoconia away from the semicircular canals. This process is gentle, non-invasive, and typically takes place in a clinic or at home under guidance.
Key Points:
- Canaliths/Otoconia: Tiny crystals involved in balance.
- Semicircular Canals: Structures in the inner ear that help sense head movements.
- Inner Ear: Responsible for controlling balance and equilibrium.
Medical professionals usually perform this approach in an office setting and help relieve vertigo in about 80% of people after one or two sessions. While symptoms can return, most people find relief after the procedure.
Purpose of the Procedure
Healthcare providers commonly use the canalith repositioning procedure for people with benign paroxysmal positional vertigo (BPPV). They move tiny loose particles away from the posterior canal in the inner ear to the utricle, where they no longer trigger dizziness and vertigo spells. This method reduces or stops episodes of positional vertigo and is especially effective for posterior canal BPPV.
Possible Complications
Some people may develop neck or back injuries from the canalith repositioning procedure, especially if they already have health problems in those areas. The process may also cause the particles in the inner ear to move to spots where vertigo continues. Temporary side effects include:
- Nausea
- Vomiting
- Dizziness
- Problems with balance
Those with prior head trauma or medical conditions should let their doctor know before treatment.
Getting Ready
- Wear loose, comfortable clothes for easy movement during the canalith repositioning.
- Stay relaxed during the Dix-Hallpike test, a simple movement-based test used to confirm the presence of BPPV.
- Ask your physician about any questions.
- No need for fasting or any special preparations.
- Make sure you can move your head and neck freely.
What You Can Expect
What Happens While You Are Being Treated
During maneuvers like the Epley or Semont, a healthcare worker guides the patient through a series of head and body movements. The provider carefully supports the head, turns it at specific angles, and watches for eye movements like nystagmus, which show how the inner ear responds.
Each position lasts about 30 seconds, or until any dizziness or strange eye movements stop. Providers may repeat these steps several times in a single session. The main goal is to guide tiny crystals in the inner ear to their correct place, which helps reduce vertigo.
| Step | Description |
|---|---|
| Head Positioning | Head is turned and angled in specific directions. |
| Body Movement | Patient rolls or moves according to instructions. |
| Monitoring | Eyes checked for nystagmus and other signs. |
| Rest Between Steps | Patient waits in each position for up to 30 seconds. |
What Happens After Treatment Is Finished
After these head movements, the provider may review Brandt-Daroff exercises or other self-care routines for home practice. Providers often ask patients to wait quietly for about 15 minutes before standing up to lower the risk of dizziness.
Patients may continue the exercises for several days to help symptoms go away completely. If dizziness returns, the Gans maneuver or similar methods may be suggested. Providers may schedule follow-up appointments to check progress and discuss any ongoing symptoms.
Findings
Most people experience improvement after the canalith repositioning procedure, with about 80% finding relief from their symptoms. The canalith repositioning maneuver gently moves crystals to a safer location in the inner ear, reducing dizziness and vertigo. If dizziness returns, the process can be repeated. Consistent follow-up with a healthcare provider helps maintain control and support habituation over time.
