Ear stones, scientifically called otoconia or otoliths, are small, naturally occurring crystals located within the inner ear. Formed from calcium carbonate, these tiny particles are an integral part of the vestibular system, the body’s balance apparatus. While normal and necessary for sensing movement, problems arise when these crystals become dislodged. This displacement interferes with inner ear function, leading to a specific, often intense, form of spinning dizziness.
The Anatomy and Function of Ear Stones
Ear stones are bio-crystals primarily composed of calcium carbonate. They range in size from about one to thirty micrometers, making them microscopic. These crystals reside within two specialized inner ear organs, the utricle and the saccule, collectively known as the otolith organs.
The otoconia are embedded in a gelatinous layer that sits on top of sensory hair cells within these organs. The weight of the crystals makes this membrane heavier than the surrounding fluid. When the head tilts or the body accelerates, the crystals’ inertia causes the weighted membrane to shift. This movement bends the sensory hair cells, sending electrical signals to the brain about linear motion and head position relative to gravity.
Understanding Benign Paroxysmal Positional Vertigo
The most common issue caused by dislodged ear stones is Benign Paroxysmal Positional Vertigo (BPPV). BPPV occurs when otoconia break free from the utricle and migrate into one of the three fluid-filled semicircular canals. The posterior semicircular canal is the most frequently affected, accounting for up to 95% of cases due to its anatomical position.
The semicircular canals are designed to sense rotational movements, like turning the head, by detecting the flow of fluid inside them. When loose, dense otoconia particles enter a canal, they disrupt the normal fluid dynamics. A change in head position causes the crystals to move under gravity, which drags the fluid and sends a false signal of spinning to the brain.
This false signal manifests as sudden, brief, and intense episodes of vertigo. These spinning sensations are triggered by specific changes in head position, such as rolling over or looking up. The vertigo is often accompanied by involuntary rhythmic eye movements called nystagmus, and sometimes nausea or vomiting. Although the symptoms are distressing, BPPV is not a sign of a serious underlying condition.
Repositioning Treatments and Recovery
The primary and highly effective treatment for BPPV is a non-invasive physical therapy technique known as a canalith repositioning procedure. The most common of these is the Epley maneuver, designed to physically guide the dislodged otoconia back to the utricle. This maneuver involves a precise series of slow head and body movements performed while the patient is seated or lying down.
The goal is to use gravity to move the crystals out of the sensitive semicircular canal and into the utricle. Once there, they can dissolve or be reabsorbed. Medical professionals, such as physical therapists or otolaryngologists, typically perform the initial diagnostic test and the maneuver itself, often providing immediate relief from symptoms.
Studies show that the Epley maneuver has a high success rate, often resolving BPPV for 80% or more of patients after one or two treatments. While immediate restrictions on head movement were once advised, recent research suggests they are not necessary for a successful outcome. Even after the spinning sensation resolves, some people may experience a mild residual unsteadiness for a few days or weeks.