Quick definition
Otoconia are tiny calcium carbonate crystals — sometimes called ear stones — that sit on top of the otolithic membrane of the inner ear and help your brain sense gravity and head tilt. When even a few of them get dislodged into a semicircular canal, they cause BPPV.
Medical definition
Otoconia are calcium carbonate (CaCO3) bio-crystals embedded in the gelatinous otolithic membrane of the utricle and saccule. They give the otolithic membrane the inertial mass it needs to deflect under gravity and linear acceleration, which the underlying hair cells convert into a neural signal. They detach with age, head trauma, vitamin D deficiency, and other less-understood mechanisms.
Why it matters in vertigo and balance disorders
Displaced otoconia are the mechanical cause of BPPV (Benign Paroxysmal Positional Vertigo). When they fall into a semicircular canal, head movements cause abnormal endolymph flow and trigger false spinning signals. The repositioning maneuvers — Epley, Semont, Gufoni, and the Bangalore Maneuver for anterior canal BPPV — physically move these crystals back to the utricle.
Where I see this in clinic
In Hindi, I often explain BPPV to patients as kaan ke patthar wali bimari — the disease of stones in the ear. It is plain, accurate, and immediately understood. Once a patient sees that BPPV is mechanical and not weakness or BP problem, compliance with the maneuver and the post-maneuver instructions improves a lot.
Related terms
Part of: Vestibular and ENT Glossary — A to Z of vestibular, balance, and ENT terms by Dr. Prateek Porwal.
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