Patients with superior canal dehiscence (SCD) suffer from events of dizziness and vertigo in response to sound, also known as Tullio phenomenon (TP). The present work seeks to explain the fluid-dynamical mechanisms behind TP. In accordance with the so-called third window theory, we developed a computational model for the vestibular signal pathway between stapes and SCD. It is based on first principles and accounts for fluid–structure interactions arising between endolymph, perilymph, and membranous labyrinth. The simulation results reveal a wave propagation phenomenon in the membranous canal, leading to two flow phenomena within the endolymph which are in close interaction. First, the periodic deformation of the membranous labyrinth causes oscillating endolymph flow which forces the cupula to oscillate in phase with the sound stimulus. Second, these primary oscillations of the endolymph induce a steady flow component by a phenomenon known as steady streaming. We find that this steady flow of the endolymph is typically in ampullofugal direction. This flow leads to a quasi-steady deflection of the cupula which increases until the driving forces of the steady streaming are balanced by the elastic reaction forces of the cupula, such that the cupula attains a constant deflection amplitude which lasts as long as the sound stimulus. Both response types have been observed in the literature. In a sensitivity study, we obtain an analytical fit which very well matches our simulation results in a relevant parameter range. Finally, we correlate the corresponding eye response (vestibulo-ocular reflex) with the fluid dynamics by a simplified model of lumped system constants. The results reveal a “sweet spot” for TP within the audible sound spectrum. We find that the underlying mechanisms which lead to TP originate primarily from Reynolds stresses in the fluid, which are weaker at lower sound frequencies.
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The work of B. Grieser was supported by the Swiss National Science Foundation (SNSF, Grant No. 205321-138298). The authors would like to thank Prof. J. Dual for helpful remarks, C.-F. Benner for his support in the course of a master’s thesis (Benner 2015), and Dr. S. Hegemann for introducing them to the Tullio phenomenon.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no competing interests.
Aibara R, Welsh JT, Puria S, Goode RL (2001) Human middle-ear sound transfer function and cochlear input impedance. Hear Res 152(1–2):100–109CrossRefPubMedGoogle Scholar
Andrews DG, McIntyre ME (1978) An exact theory of nonlinear waves on a Lagrangian-mean flow. J Fluid Mech 89(4):609–646CrossRefGoogle Scholar
Benner CF (2015) Fluid-dynamic study of sound-induced vertigo. Master thesis, Institute of Fluid Dynamics, ETH Zürich, doi:10.3929/ethz-a-010395756
Boluriaan S, Morris PJ (2003) Acoustic streaming: from Rayleigh to today. Int J Aeroacoust 2(3):255–292CrossRefGoogle Scholar
Bradley C (2012) Acoustic streaming field structure. Part II. Examples that include boundary-driven flow. J Acoust Soc Am 131(1):13–23CrossRefPubMedGoogle Scholar
Carey JP, Minor LB, Nager GT (2000) Dehiscence or thinning of bone overlying the superior semicircular canal in a temporal bone survey. Arch Otolaryngol Head Neck Surg 126(2):137–147CrossRefPubMedGoogle Scholar
Carey JP, Hirvonen TP, Hullar TE, Minor LB (2004) Acoustic responses of vestibular afferents in a model of superior canal dehiscence. Otol Neurotol 25(3):345–352CrossRefPubMedGoogle Scholar
Cremer P, Minor L, Carey J, Della Santina C (2000) Eye movements in patients with superior canal dehiscence syndrome align with the abnormal canal. Neurology 55(12):1833–1841CrossRefPubMedGoogle Scholar
Curthoys IS, Oman CM (1987) Dimensions of the horizontal semicircular duct, ampulla and utricle in the human. Acta Otolaryngol 103(3–4):254–261CrossRefGoogle Scholar
Edom E, Obrist D, Kleiser L (2014) Steady streaming in a two-dimensional box model of a passive cochlea. J Fluid Mech 753:254–278CrossRefGoogle Scholar
Gautier F, Gilbert J, Dalmont JP, Picó Vila R (2007) Wave propagation in a fluid-filled cylindrical membrane. Acta Acust 93:333–344Google Scholar
Gerstenberger C, Wolter FE (2013) Numerical simulation of acoustic streaming within the cochlea. J Comput Acoust 21(4:1350019):1–37Google Scholar
Grieser B (2015) Fluid-mechanical model for vestibular responses to sound in presence of a superior canal dehiscence. PhD Thesis, ETH Zürich, Dissertation No. 22681, available onlineGoogle Scholar
Grieser B, McGarvie LA, Kleiser L, Manzari L, Obrist D, Curthoys IS (2014) Numerical investigations of the effects of endolymphatic hydrops on the VOR response. J Vestib Res 24(2–3):219Google Scholar
Grieser B, Kleiser L, Obrist D (2015) tullioFoam—a numerical model of the Tullio phenomenon. ETH E- Collections ETH Zürich, doi:10.3929/ethz-a-10435235
Minor LB (2005) Clinical manifestations of superior semicircular canal dehiscence. Laryngoscope 115(10):1717–1727CrossRefPubMedGoogle Scholar
Minor LB, Solomon D, Zinreich SJ, Zee DS (1998) Sound-and/or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal. Arch Otolaryngol Head Neck Surg 124(3):249–258CrossRefPubMedGoogle Scholar
Minor LB, Cremer PD, Carey JP, Della Santina CC, Streubel SO, Weg N (2001) Symptoms and signs in superior canal dehiscence syndrome. Ann N Y Acad Sci 942(410):259–273PubMedGoogle Scholar
Niesten MEF, Stieger C, Lee DJ, Merchant JP, Grolman W, Rosowski JJ, Nakajima HH (2015) Assessment of the effects of superior canal dehiscence location and size on intracochlear sound pressures. Audiol Neuro Otol 20(1):62–71CrossRefGoogle Scholar
Rosowski JJ, Songer JE, Nakajima HH, Brinsko KM, Merchant SN (2004) Clinical, experimental, and theoretical investigations of the effect of superior semicircular canal dehiscence on hearing mechanisms. Otol Neurotol 25:323–332CrossRefPubMedGoogle Scholar