Expert Perspectives on Developing Mixed Reality Software for Benign Paroxysmal Positional Vertigo Management: A Qualitative Study

Background: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disorder, yet its management often varies due to inconsistent maneuver execution and clinician training. Mixed reality offers potential to standardize procedures and enhance user guidance. This study explored expert perspectives to inform the development of mixed reality software designed to facilitate the diagnosis and management of BPPV. Methods: A qualitative descriptive study was conducted among 17 clinicians with experience in vestibular care. Participants completed a structured online questionnaire containing open-ended items, and responses were analyzed thematically to identify key design priorities and safety considerations. Results: Thematic analysis identified four major domains: Essential Clinical Features, Functional Enhancements, Perceived Adverse Effects, and Implementation Considerations. Experts highlighted the need for step-by-step procedural guidance, angle-specific head and body measurements, visual and interactive aids, and tools for nystagmus detection. Potential adverse effects, including eye strain, vertigo exacerbation, and nausea, were also emphasized. Implementation priorities included high-definition display quality, lightweight hardware, affordability, and ease of use. Conclusion: Expert feedback underscored the need for mixed reality systems that prioritize procedural accuracy, usability, and safety. These findings provide an expert-informed framework for a user-centered mixed reality prototype that can be refined and evaluated in future clinical settings.