Virtual simulation of otolith movement for the diagnosis and treatment of benign paroxysmal positional vertigo.

Benign paroxysmal positional vertigo (BPPV) is a clinical condition. The existing diagnostic methods cannot determine the specific location of otolith on the short or long brachial sides. Thus, visual and quantitative evaluation of the existing clinical standard diagnostic modality Dix-Hallpike test is needed to improve medical efficiency. Our goal was to develop a real-time virtual simulation system to assess a BPPV treatment manipulation. In this study, we used the proposed simulation system to observe otolith movement during a posterior semicircular canal BPPV diagnostic test, and to analyze the diagnostic mechanisms and strategies. Through visual cluster analysis of otolith position and analysis of otolith movement time in the standard Dix-Hallpike test, we can find that the positions of otoliths are relatively scattered, especially on the -axis (  = 10.67 ± 3.98), and the fall time of otoliths at different positions has relatively large changes (  = 22.21 ± 1.40). But in the modified experiment  = 4.93 ± 0.32 and  = 26.21 ± 0.28. The experimental results show that the simulation system could track the state and the movement of otolith in real-time, which is of great significance for understanding the diagnostic mechanisms of BPPV evaluations and improving the diagnostic method.