Can numerical modeling help us understanding hydrops in Menière's disease? A PRISMA scoping review

BackgroundThe pathophysiology of Meniere's disease (MD) is complex and intertwined with endolymphatic hydrops. Available experimental models have limitations.ObjectiveThis study aimed to analyze the impact of endolymphatic hydrops on cochleovestibular hydrodynamics through numerical simulations.MethodsA comprehensive literature review was conducted following PRISMA guidelines for Scoping Reviews. Articles were sourced in June 2024 from PubMed and Google Scholar using a combination of MESH terms related to hydrodynamics, numerical simulation, and MD. Studies involving numerical simulations of hydrops in the vestibule, cochlea, or both were included.ResultsEight studies on hydrodynamics in hydrops using numerical simulations were included. In cochlear models, hydrops affect basilar membrane mechanics, causing low-frequency hearing loss, auditory distortions, and frequency shifts. Vestibular models revealed increased static pressure in the horizontal semicircular canal, explaining abnormal vHIT findings in hydrops patients. Models also suggested chaotic fluid dynamics in dilated labyrinthine structures during caloric tests. The reviewed studies underscore the utility of numerical models in understanding the mechanics of MD; however, significant limitations were identified.ConclusionsNumerical modeling offers valuable insights into the hydrodynamic changes caused by endolymphatic hydrops in MD, but future work should address the current limitations by incorporating more accurate anatomical features and chronic progression in simulations.