Often dizzy, many people immediately think of cervical spondylosis, Meniere's disease, posterior circulation ischemia, etc. However, quite a few times, this stems from "otolithiasis". Professor Xi Gangming pointed out that head trauma or long-term fixed posture, such as bowing the head to play with a mobile phone, continuous neck rotation, etc., may induce otolithiasis.
The patient is being examined.
What is otolithiasis?
Is there really a stone in the ear?
Benign paroxysmal positional vertigo, commonly known as otolithiasis, is manifested by transient vertigo and characteristic nystagmus, and is a common peripheral vestibular disorder. At the end of the inner ear of our ear, there are two membranous sacs, the utricle and the balloon, which are filled with carbonate crystals that can sense the change of center of gravity, and are shaped like stones, which are called "otoliths" in medicine.
Professor Xi Gangming introduced that under normal circumstances, otoliths are adhered to the utricle and balloon, but in the case of trauma, strenuous exercise, senile degeneration, ear diseases, etc., the canalith may be caused to detach from its original position and enter the three "C" shaped semicircular canals connected to it. After the canalith falls off, it enters the lymphatic fluid in the semicircular canals, which stimulates the balance receptors and induces balance disorders, which manifests as spinning, nystagmus, nausea and vomiting. The most common is vertigo when sitting up, lying down, turning side-to-side, bending over, and looking up, and the vertigo improves when the head is fixed, so the patient is very frightened.
The incidence of otolithiasis is extremely high
Young people are also one of the most common groups
Professor Xi Gangming pointed out that most of the otolithiasis is of unknown cause, and the incidence of otolithiasis accounts for 30% of vertigo patients, mostly middle-aged and elderly people over 50 years old, and patients with a history of "three highs" (hypertension, hyperlipidemia, and hyperglycemia). Sudden deafness, Meniere's disease, vestibular neuronitis, etc., are prone to secondary diseases; There are also people who have been bedridden for a long time, and they are also prone to otolithiasis because they cannot get out of bed and move because they are fixed in one position for a long time.
In general, the peak age of otolithiasis is 40-60 years old. However, in recent years, with the change of people's lifestyle, the incidence of otolithiasis has gradually increased, and the annual incidence rate is as high as 107 100,000 - 600 100,000, with a lifetime prevalence of about 24%, especially young people with fear of heights, motion sickness, seasickness, etc., have also become one of the high-incidence groups, which may be related to the underlying vascular mechanism.
Nowadays, young people who are under pressure for a long time, often stay up late, and are overtired, may be because of these bad living conditions, which cause spasm and ischemia of the small arteries of the inner ear, which leads to the occurrence of otolithiasis. In addition, bowing your head to play with mobile phones and using computers, and being in a bad head posture for a long time will aggravate inner ear vasospasm and cell ischemia, making canaliths more likely to fall off and cause disease.
Professor Xi Gangming is explaining otolithiasis.
Vertigo Specialized Clinic——
Treat the disease and treat the cause of vertigo
Vertigo is a clinical syndrome that is the most common symptom after headache and ranks second in hospital outpatients. Vertigo is complex, involving hundreds of diseases, including cerebrovascular diseases, anxiety and depression, vestibular migraine, otolithiasis, Meniere's disease, heart diseases, etc., involving multiple clinical departments. To this end, Shanghai Blue Cross Brain Hospital has opened a special outpatient clinic for vertigo and established a multidisciplinary vertigo team. On the basis of standardization, it is combined with traditional Chinese medicine, physiotherapy, vestibular function and other means to achieve vertigo diagnosis and integration.
For patients diagnosed with otolithiasis, the preferred method is canalith reduction**, which often has an immediate effect**. Otolith replacement** is further divided into manual manual repositioning and instrumental repositioning**.
Manual reduction belongs to the traditional canalith reduction, which is to change the position of the patient's head through manual operation, so that the fallen otolith can return to its original place to achieve the best purpose. However, there are obvious limitations, such as for patients with cervical and lumbar spine diseases, obesity, advanced age, etc., manual reduction position change is limited, which affects the efficacy of reduction, or even cannot be carried out at all.
The vertigo diagnosis and treatment system integrates examination and diagnosis, after fixing the patient on the seat, the patient is accurately rotated through the rotation axis, and the infrared nystagmus system is used to record the patient's nystagmus in real time, accurately locate the lesion semicircular canal, and realize multi-directional roll reduction, real-time dynamic detection throughout the process, and the diagnosis is accurate, safe and effective. During diagnosis and reduction, the whole body can be driven by the seat to rotate as a whole, which avoids the stimulation of the patient's neck and waist, and effectively makes up for the defects of manual reduction.
Fully automatic vertigo diagnosis and treatment system.
It is now fully operational. In addition to precise localization and reduction of otolithiasis**, it can also be used to assess the function of the semicircular canals, vestibular otoliths, vestibular center, and cerebral cortex in the following areas:
1.It is suitable for the diagnosis and treatment of various otolithiasis, and designs personalized plans for refractory otolithiasis to achieve accuracy.
2.It is suitable for auxiliary examination of vestibular diseases such as Meniere's disease, sudden deafness and vertigo.
3.Other features:
A variety of vestibular function tests (spontaneous nystagmus test, positional test, displacement test, fixation test, rotational emergency stop test, sinusoidal swing test, etc.).
Functional tests were performed on three different sets of semicircular canals.
Motion sickness (motion sickness, seasickness, airsickness, space motion sickness, etc., also known as motion sickness) and uniform training.
Targeted training is performed for each set of different semicircular canals.
Selection and evaluation of special occupational groups.
A comprehensive simulation and reproduction platform for vestibular function research and clinical reference vestibular function testing, ** evaluation, etc.
For the clinical symptoms such as dizziness, fear of heights, stiff neck muscles, shoulder and neck pain, and wearing a band on the head caused by atypical otolith heterotopia.
What should I look out for after canalith replacement?
Professor Xi Gangming reminded that vertigo patients diagnosed with otolithiasis, after the otolith is reset, the patient still needs to cooperate with the adjustment of living habits within 48 hours, and the specific needs to be done are as follows
1. Walking posture:When walking, look straight ahead, do not change the head position at will, and try to use the rotation of the body to assist the head position change;
2. Sleeping position:It is recommended to sleep with your upper body raised 30 degrees;
3. Avoid strenuous exerciseSuch as running, playing ball, skipping rope, etc.;
4. Avoid looking up and bowing your head:Such as raising your head to dry clothes, mopping the floor with your head down, looking down at your mobile phone, etc.;
5. Prohibited:It is forbidden to work at height and drive;
6. Outpatient follow-up:It is recommended to visit an outpatient clinic 1 week after reduction to determine if the canalith is reduced.