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Canalith repositioning procedure
By Mayo Clinic staffMayo Clinic Health Manager
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Definition
The canalith repositioning procedure can help relieve benign paroxysmal vertigo (BPPV), a condition in which you have brief but intense episodes of dizziness that occur when you move your head. Vertigo usually comes from a problem with the part of the inner ear responsible for balance (vestibular labyrinth). BPPV occurs when tiny particles called canaliths in one part of your inner ear break loose and fall into the canals of your inner ear, causing vertigo.
The canalith repositioning procedure can move the canaliths to a part of your ear where they won't cause dizziness. Performed in your doctor's office, the canalith repositioning procedure consists of several simple head maneuvers.
Why it's done
The canalith repositioning procedure is performed to move the symptom-causing canaliths from your inner ear to a tiny bag-like structure in your ear called the utricle. Once there, these particles won't cause vertigo and will likely be reabsorbed by the bodily fluids in your ear.
Risks
The canalith repositioning procedure should always be performed under the supervision of a medical professional. Without a doctor or trained professional to help you, you could fall and injure yourself.
There's a small risk that the canaliths could move into a canal other than the utricle and continue to cause vertigo, but this risk is very small. More common side effects of the procedure include feelings of nausea, dizziness and lightheadedness. Let your doctor know if this happens. You may be given medication to relieve these side effects.
If you've had a recent neck or back injury, you may need to delay having the canalith repositioning procedure. Make sure you tell your doctor about any medical conditions you have before beginning the maneuvers.
How you prepare
There are no special preparations for the canalith repositioning procedure. You should wear clothing that will allow you to move freely through each of the maneuvers.
What you can expect
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Step 1: Moving to a reclining position |
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Step 2: Turning your head to a 90-degree angle |
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Step 3: Rolling onto your side |
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Step 4: Returning to a sitting position |
During the procedure
The canalith repositioning procedure involves holding four positions for 30 seconds each after your symptoms have stopped while you hold that position. Depending on your doctor's preferences, you may wear an infrared imaging device over your eyes, as shown in the photographs here. This device helps your doctor see your eyes during each maneuver. The device can help your doctor determine if each maneuver is being done properly, but it isn't necessary for successful treatment.
Here are the steps involved in the canalith repositioning procedure.
Step 1. First you move from a sitting to a reclining position. Your doctor will help extend your head over the edge of the table at a 45-degree angle.
Step 2. With your head still extended over the edge of the table, your doctor will prompt you to turn your head to the right about 90 degrees.
Step 3. Roll onto your side. Your head should be slightly angled while you look down at the floor.
Step 4. Finally, you return carefully to a sitting position and then tilt your head down.
After the procedure
After the procedure, you'll need to keep the treated ear above the level of your shoulder for the rest of that day. At night, you should sleep on a slight incline with your head above your shoulders, using a few pillows. This lets the particles floating in your vestibular labyrinth settle into your utricle or be reabsorbed by your body fluids.
The next morning, you'll perform the same maneuvers by yourself to check whether the procedure in the office was effective. If your vertigo continues, tell your doctor. You'll likely need to perform a version of the canalith repositioning procedure for several days before your symptoms subside.
Results
Most of the time, people who undergo the procedure do not experience any additional episodes of vertigo. Some people have symptoms of mild imbalance that improve within as little as 48 hours of the maneuvers, whereas others may take up to two weeks to see improvement.
It may be necessary to repeat the procedure several times to relieve your symptoms. Talk to your doctor if you have the procedure and your symptoms don't improve.
