What is canalith repositioning?

Canalith repositioning treats benign paroxysmal positional vertigo (BPPV). BPPV is a condition that causes vertigo when you move your head into specific positions, such as lying on your back or moving your head to the side. BPPV occurs when crystals in your inner ear (called otoconia) are moved out of position and are not absorbed by the fluid in the inner ear.

To fix the problem, the otoconia needs to be moved to the proper position. We do that by performing canalith repositioning. Canalith repositioning is done in the office and takes about 15 minutes. It involves laying the patient down on a table and maneuvering the head to a very specific angle in order to move the otoconia out of the problem area.

A second maneuver is then performed to place the otoconia into the proper position. It is highly recommended that you see a professional for this treatment. Do not try and do this on your own. If it is done incorrectly, the otoconia can be moved into the horizontal semicircular canal which can cause a different, more intense type of dizziness. Colorado Ear Care performs canalith repositioning.

What is vestibular rehabilitation therapy?

Vestibular rehabilitation therapy (VRT) is an exercise-based treatment program designed to promote vestibular adaptation. The goals of VRT are dependent on the needs of the patient, but often includes enhancing the relationship between vision, proprioception and the vestibular system.

The brain uses all three of these senses to maximize coordination and balance. Common exercises for VRT include head-eye movements with differing body postures and activities, and maintaining balance with varying levels of support from the lower body.

Colorado Ear Care does not offer vestibular rehabilitation therapy but does work with multiple physical therapists that do offer VRT.

If you’re experiencing equilibrium or balance issues that are related to a vestibular disorder, then you’re likely an ideal candidate for canalith repositioning or vestibular rehabilitation therapy.

Without proper examination, diagnosis is only speculative, but it’s important to note that natural aging, head trauma, disease, infections, and other illnesses can have a negative effect on the inner ear, which is the source of 85% of all dizziness.

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How do you perform the Epley maneuver?

The Epley maneuver is an exercise that helps to treat Benign Paroxysmal Positional Vertigo (BPPV). It involves moving the head at specific angles while lying down in order to move otoconia (crystals) into the proper position within the posterior semicircular canal. The Epley maneuver, and all canalith repositioning maneuvers should be performed by a trained professional. There are YouTube videos about how to perform a ‘home Epley maneuver’, but this is not recommended. Performing an Epley incorrectly can cause the crystals to migrate into the horizontal semicircular canal which will create a different, more intense vertigo. It is also often difficult for people to achieve the correct positions and angles on their own that would lead to a successful maneuver.

At Colorado Ear Care, we perform the Semont Liberatory maneuver versus the Epley. In our experience, the Semont maneuver is just as effective in treating BPPV without the need for hyperextension and rotation of the neck and bending at the waist that is required by the Epley. The Semont maneuver also allows the provider to support the patient if they have a significant amount of vertigo, which is safer.

If you are experiencing dizziness or balance problems, we highly recommended having a full vestibular evaluation done in order to determine the origin of your dizziness. Although BPPV is common, there can be other causes of the dizziness not associated with head movement.