(0915) Computational Fluid Dynamics Simulation of Otolith Movement and Its Relation to Benign Paroxysmal Positional Vertigo

Introduction: The text discusses Benign Paroxysmal Positional Vertigo (BPPV) and underscores the significance of the vestibular system, particularly in the context of repositioning maneuvers employed for treatment. The research rationale is rooted in comprehending potential causes of treatment failure, and the existing literature underlines prior studies on otoconia dynamics while emphasizing the lack of research focusing specifically on the 3 semicircular canals individually.

Methods: The simulation methodology involves creating a 3D model in Autodesk Fusion 360 for otoconia movement in the inner ear's semicircular canals during repositioning maneuvers. ANSYS FLUENT, using computational fluid dynamics, considers continuous (endolymph) and dispersed (otoconia) phases. Repositioning maneuvers (Epley, Gufoni, Yacovino) are applied, and ANSYS Fluent generates profiles, contours, and particle tracking to assess maneuver effectiveness compared to a control under standard conditions.

Results: Simulation outcomes show that the Epley Maneuver in the posterior canal consistently exhibits velocity profiles and contours for different particle sizes, with maximum velocity post-ampulla. The Gufoni Maneuver in the vertical canal yields similar results to Epley, indicating variations along the canal. Smaller particles have higher success rates, with accumulation in the ampulla zone. The Yacovino Maneuver for the horizontal canal reveals distinct velocity and pressure features, with smaller particles more likely to reach the macula.

Conclusions: This study, shows an anatomical standardization and ANSYS simulations, providing insights into particle dynamics in the vestibular system. Repositioning maneuvers exhibit heightened success, particularly for smaller particles, yet a notable percentage persists in canals, peaking at 90% in the horizontal canal. Varied difficulty levels among canals highlight the Gufoni maneuver's comparatively lower effectiveness. The persistent BPPV occurrences highlight the need for a thorough comprehension of particle behavior in clinical settings.