Where are the ear crystals?
Each inner ear, or vestibular system, has three semi-circular canals – the posterior, the anterior and the horizontal canal. Ear crystals live on a membrane in a nearby vestibular sensory organ called the utricle. All of the semi-circular canals share fluid with the utricle, so the ear crystals can float into the semi-circular canals if they break off the membrane.
The runaway ear crystals cause BPPV (Benign Paroxysmal Positional Vertigo).
There is a shared entry point of the posterior and anterior canal connecting to the utricule where the ear crystals normally live is called the “common crus.” The horizontal canal connects with the utricle also.
In a case of BPPV, a person can have a misplaced crystal(s) floating in any of one or combination of their 6 inner ear canals. Those crystals are supposed to be in the utricle organ in the inner ear, but when a person has BPPV, the crystals have moved and gone floating in one of the semi-circular canals.
This can happen through hormone changes, head trauma or normal aging (amongst other causes).
Most people likely have more than one crystal floating loose, possibly even a sediment of thousands of ear crystals.
Sometimes people even have BPPV in both ears. Anyone with a head injury is most likely going to have it in both ears because each ear probably had ear crystals break loose from the trauma and go floating away from where it belongs into a semi-circular canal.
Risks of Self-Treatment for Ear Crystals
The reason the self-Epley treatment does work for a lot for people is because the inner ear canals are not totally set horizontal in relation to gravity. The posterior canal is a little lower in the head than the others, making it the most common place the crystals end up. The Epley maneuver only treats the posterior canal.
If people don’t do the treatment right, or they have a sediment of ear crystals, then they can convert it to the horizontal or anterior canal.
If people have a lot of crystal sediment in their canal and they improperly treat themselves with the Epley maneuver, the crystals end up converting into the other canal because they don’t pass through the common crus.
Then the person ends up with ear crystals in two canals! A so-called “canal conversion.”
And that’s much more difficult to treat, but still possible in more treatment sessions.
I see this result in people that try to treat themselves and from clinicians that are not well trained in the maneuvers, those that are “dabbling.”
People with “multi-canal BPPV” and persistent BPPV are the patients I usually need to see more than once. They may need 2-3 visits with me, or more in order to completely resolve their complaints of ear crystals.
Due to the risk of not doing the treatment correctly, fear of falling during the maneuver, possibility of a panic attack, and the need for an assessment to determine if other canals are involved, I do not recommend for people to try to treat themselves for BPPV ear crystals.
In my practice, I see a lot of patients who have all types of BPPV and all combinations of canals with ear crystals, and I get excellent results with these patients.
This blog is provided for informational purposes only. The content and any comments by Dr. Kim Bell, DPT are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The details of any case mentioned in this post represent a typical patient that Dr. Bell might see and do not describe the circumstances of a specific individual.