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Identifying Mechanisms Behind the Tullio Phenomenon: a Computational Study Based on First Principles.

Bernhard J Grieser1, Leonhard Kleiser1, Dominik Obrist2

  • 1Institute of Fluid Dynamics, ETH Zurich, Sonneggstr. 3, CH-8092, Zurich, Switzerland.

Journal of the Association for Research in Otolaryngology : JARO
|February 18, 2016
PubMed
Summary

Superior canal dehiscence (SCD) causes sound-induced dizziness (Tullio phenomenon) by creating fluid dynamics in the inner ear. This study models these mechanisms, revealing wave propagation and steady endolymph flow that deflect the cupula.

Keywords:
fluid dynamicsfluid–structure interactionslow-phase eye velocitysteady streamingsuperior canal dehiscence

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Area of Science:

  • Vestibular system physiology
  • Fluid dynamics
  • Computational modeling

Background:

  • Superior canal dehiscence (SCD) is a condition causing sound-induced dizziness and vertigo, known as Tullio phenomenon (TP).
  • The exact fluid-dynamical mechanisms underlying TP remain incompletely understood.
  • Existing theories often simplify the complex fluid-structure interactions within the inner ear.

Purpose of the Study:

  • To elucidate the fluid-dynamical mechanisms responsible for the Tullio phenomenon in superior canal dehiscence.
  • To develop and validate a computational model of the vestibular signal pathway affected by SCD.
  • To investigate the interaction between fluid flow and cupular motion in response to sound stimuli.

Main Methods:

  • Developed a first-principles computational model of the vestibular system, incorporating fluid-structure interactions between endolymph, perilymph, and the membranous labyrinth.
  • Simulated wave propagation within the semicircular canal in response to sound stimuli.
  • Analyzed endolymph flow dynamics, including oscillating and steady flow components (steady streaming).
  • Modeled the vestibulo-ocular reflex (VOR) by correlating fluid dynamics with eye response.

Main Results:

  • Identified wave propagation in the membranous canal leading to oscillating endolymph flow and cupular oscillation in phase with sound.
  • Demonstrated that primary oscillations induce steady, ampullofugal endolymph flow (steady streaming), causing quasi-steady cupular deflection.
  • Found a "sweet spot" for TP within the audible sound spectrum, with underlying mechanisms originating from Reynolds stresses, which are weaker at lower frequencies.
  • Analytical fits closely matched simulation results across a relevant parameter range.

Conclusions:

  • The study provides a detailed fluid-dynamical explanation for Tullio phenomenon in superior canal dehiscence.
  • Both oscillating and steady endolymph flows contribute to cupular deflection and associated vestibular symptoms.
  • The findings highlight the importance of fluid-structure interactions and Reynolds stresses in the pathogenesis of TP, with frequency-dependent effects.