Canalith Repositioning Procedure

One of the first steps in the evaluation of dizziness is an electronystagmography test, or ENG.  For some types of dizziness, a simple 20-minute treatment that is performed here at ACA, called canalith repositioning, can result in dramatic improvement — or even complete elimination — of symptoms. The type of dizziness that this procedure can frequently help is called Benign Paroxysmal Positional Vertigo (BPPV).

Benign means “not life threatening.”  Paroxysmal means “a short burst.”  Positional means “in certain positions” and vertigo means “a true spinning sensation.”  In short, BPPV is occasional, brief bursts of dizziness when your head is in certain positions. Though this condition is not life threatening, it is often extremely uncomfortable.

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Within the balance organs are structures called the semi-circular canals.  In these canals, there are little crystals or canaliths that are usually attached at the base of the semi-circular canal.  For some reason, the canaliths in the inner ear can become disattached from the base.  As a result, when a person with BPPV moves his or her head in certain directions, the canaliths move through the canals and cause a dizzy feeling. Some of the reasons that the canaliths can become disattached include head trauma, aging factors or certain medications.

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Sometimes, BPPV resolves itself, but it may be necessary to reposition the canaliths back in the base of the semi-circular canal.  Through a series of head movements and body positions we can put the canaliths where they belong.  This is called the Canalith Repositioning Procedure, or “CRP”. This procedure is non-invasive and takes relatively little time.  CRP has been proven to be approximately 85% effective, but sometimes it needs to be repeated.  After the procedure is completed, there are follow up instructions that must be followed to help insure the procedure is successful.  The theory behind the follow up instructions is that once we reposition the canaliths, we must keep them in place so that they can reattach to the base of the semi-circular canal.

Patients undergoing CRP are typically given the following instructions:

  • For 48 hours after undergoing CRP, it will be important to keep your head and neck moving as one unit. A soft neck collar will help you remember not to make any gross up and down head movements.
  • For the following two nights, you will need to sleep at a 45 degree angle.  This can be accomplished by sleeping in a recliner or by putting several pillows behind you in bed.  It is important that you do not sleep in a completely horizontal position.
  • After two nights of sleeping sitting up, you may return to lying down, but do not sleep on your side for the next five nights.  If you are concerned you may turn on that side in your sleep, put a tennis ball in your pajama pocket, or pin a pillow to that side.
  • During the follow-up week, always be conscious of moving your head and neck as one unit.
  • If you continue to have dizziness after returning to your regular routine after the week of following these instructions, contact ACA to schedule a follow up appointment.  REMEMBER:  It may be necessary to repeat the procedure more than once.

Dizziness is not normal.  If you experience regular or constant dizziness or loss of balance, consult your audiologist or physician immediately.