Recently, 70-year-old Tang Apo came to the Neurology Clinic of Jiuting Hospital in Songjiang District under the support of his wife, and it turned out that Tang Apo was plagued by vertigo for many days, and was treated with intravenous fluids in a third-class hospital in the city for nine days, and there was no sign of improvement in vertigo symptoms. Zheng Wei, chief physician of the neurology department of the hospital, received Aunt Tang. After a detailed examination of the patient, Zheng Wei found that the elderly suffered from the rare bilateral posterior semicircular canal otolithiasis. Because it is a bilateral lesion, this brings a certain degree of difficulty to the treatment of otolithiasis.
After a comprehensive evaluation, Zheng Wei formulated a two-step treatment plan, three times through the method of manual reduction, Aunt Tang's vertigo symptoms gradually disappeared, and the condition also improved.
Coincidentally, Ms. Wang of Yangpu District could not work normally because of vertigo, and did not dare to turn her head for three months, accompanied by serious anxiety. Later, she heard that Dr. Zheng Wei of Jiuting Hospital had a very good effect on treating vertigo, so she and her husband drove from Yangpu District to the hospital. Zheng Wei carefully inquired about the medical history and physical examination and found that the patient was also a case of posterior semicircular canal otolithiasis, due to fear of the onset of vertigo, the head has been twisted to one side for three months to force the head position, resulting in spasm and stiffness of one side of the neck muscles.
After careful evaluation, Zheng Wei also underwent the method of manual reduction, and Ms. Wang's vertigo symptoms immediately improved, and then gave drugs to Ms. Wang's anxiety symptoms Zheng Wei to treat them symptomatically. In the days that followed, Ms. Wang's anxiety about vertigo also improved considerably.
It is understood that the number of otolithiasis patients who have been cured by Dr. Zheng Wei since 2019 has exceeded 500 cases.
With the completion of the first phase of the reconstruction and expansion project of Jiuting Hospital, the hospital is gradually moving towards the goal of a regional medical center. Manual reduction of otolithiasis is also a clinical skill that is clearly required by regional medical centers to solve the problems of otolithiasis patients.
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What is otolithiasis?
Under normal circumstances, otoliths are attached to the otolithic membrane and are organs that maintain the balance of the human body. When some pathogenic factors cause the otolith to detach, these fallout otoliths will swim in the fluid called endolymphatic fluid in the inner ear, and when the human head position changes, these semicircular canals also change position, and the depressed otoliths will move with the flow of liquid, thereby stimulating the hair cells of the semicircular canal, resulting in intense dizziness in the body.
Principles of manual reduction therapy
Manual reduction is through a series of head transformations, with the help of gravity to sink and displace the otolith particles, and gradually remove the otolith particles entering the semicircular canal sequentially out of the semicircular tube back into the elliptical sac, thereby eliminating the effect of the otolith particles on the amphora crest, to achieve the purpose of treatment, clinical can be divided into tube stone relief method and tube stone reduction method.
Precautions for manual reduction
1. Those who cannot tolerate treatment due to vertigo can take sedatives or vestibular inhibitors before undergoing reduction therapy;
2. Patients with high blood pressure or neck and back diseases should be used with caution;
3. Avoid lying on your back for at least 2 days after manual reduction.
Correspondent: Wei Min
Editor: Lina Shen