Canalith Repositioning Procedure

Canalith repositioning procedure is a treatment for Benign Paroxysmal Positional Vertigo (BPPV). BPPV is a condition of vertigo in which there is a sensation of the head spinning and episodes of dizziness are experienced when there is a particular movement of the head.

The otolith organ is responsible for the sensitivity to gravity as well as movements of the head and hence is essential to maintain the balance of the body. BPPV occurs due to the dislodging of crystals of the otolith organ into the semi-circular canals of the ear. In the canalith repositioning procedure, these otolith crystals are removed from the semi-circular canal and are re-positioned in the utricle. 

Symptoms

The symptoms of BPPV are:

• Dizziness
• Feeling of the head spinning
• Lack of balance
• Nausea
• Vomiting
• Severe headache
• Double vision
• Abnormal, frequent eye movements

Diagnosis

A Benign Paroxysmal Positional Vertigo can be diagnosed by Electronystagmography (ENG) or the Dix-Hallpike test which uses electrodes to observe irregular eye movements in different positions of the head. The doctor can physically examine the eye movements when the head is resting compared to when it is slightly tipped, which also helps determine the requirement of a Canalith Repositioning Procedure. CT scan and MRI scan like imaging tests can also be carried out to rule out the possibilities of other types of vertigo. 

Treatment

There are two techniques of the Repositioning procedure:

• Epley maneuver
• Semont-Liberatory maneuver

Risks

There are several risks involved in a Canalith Repositioning Procedure. There may be a neck or back injury along with side effects such as nausea, dizziness and weakness. The patient is also susceptible to vertigo if the otoconia moves into a canal other than the utricle. There are chances of a canalith jam in which there is a blockage during the movement of the canaliths from a broadened area to a narrowed area. 

After Procedure

After a Canalith Repositioning Procedure, it is essential to keep the ear level raised than the shoulder. Hence, the patient must not lie flat for at least one day and should keep the head elevated using a recliner chair or pillows. The doctor may teach the patient the positions of the maneuver and then these exercises have to be done at home until the vertigo stops completely.