外半规管良性阵发性位置性眩晕诊断试验分析和物理引擎耳石运动观察

doi:10.16098/j.issn.0529-1356.2020.02.016

解剖学报 ›› 2020, Vol. 51 ›› Issue (2): 245-251.doi: 10.16098/j.issn.0529-1356.2020.02.016

外半规管良性阵发性位置性眩晕诊断试验分析和物理引擎耳石运动观察

杨晓凯*

温州医科大学温州市第三临床学院，温州市人民医院神经内科, 浙江温州 325000

收稿日期:2019-01-17 修回日期:2019-04-04 出版日期:2020-04-06 发布日期:2020-04-06
通讯作者: 杨晓凯 E-mail:yakeworld@126.com
基金资助:
温州市重大科技专项;浙江省自然科学基金

Analysis of the diagnosis maneuver of lateral semicircular canal benign positional paroxysmal vertigo and observation of the otolith movement using physical engine

YANG Xiao-kai*

Department of Neurology, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People’s Hospital, Zhejiang Wenzhou 325000,China

Received:2019-01-17 Revised:2019-04-04 Online:2020-04-06 Published:2020-04-06
Contact: YANG Xiao-kai E-mail:yakeworld@126.com

摘要/Abstract

摘要：

目的对外半规管良性阵发性位置性眩晕（BPPV）诊断试验进行分析，了解其诊断机制。方法建立基于物理引擎三维物理仿真的BPPV迷路模型，设定外半规管不同位置结石，分析水平滚转试验过程不同位置耳石运动情况，进而可以推断所诱发眼震表现。结果水平滚转试验眼震表现形式多样，包括双侧背地眼震，可以判断为壶腹部结石和嵴帽结石，眼震弱侧为患侧；双侧向地眼震，可以判断为外半规管长臂侧结石，眼震强烈侧为患侧；一侧背地眼震一侧向地眼震，考虑长臂侧壶腹部结石；水平滚转试验存在的设计缺陷是会导致耳石复位，影响诊断试验的敏感性。10次重复试验结果一致。结论 60°水平滚转试验有效修正了90°水平滚转试验存在的缺陷。基于物理引擎对诊断试验进行分析，对于我们理解外半规管BPPV的诊断机制有重要意义，也有助于改良和创新诊断方法。

关键词: 外半规管, 良性阵发性位置性眩晕, 诊断, 耳石, 物理引擎, 仿真分析, 人

Abstract:

Objective To analysis the diagnosis maneuvers of lateral semicircular canal benign positional paroxysmal vertigo (BPPV) and to explore the diagnostic mechanism. Methods The three-dimensional BPPV labyrinth model was established based on the physical engine. The otolith in different positions of the lateral semicircular canal was set up. The otolith movement in different positions during the horizontal roll test was analyzed, and the induced nystagmus could be inferred. Results Horizontal roll test nystagmus manifestations were diverse, including bilateral ageotropic nystagmus, which could be judged as otolith in ampullary and crista, and weak side of nystagmus was the affected side; bilateral geotropic nystagmus could be judged as otolith in the long arm of the lateral semicircular canal, and strong side of nystagmuss was the affected side; Ageotropic nystagmus in one side and geotropic nystagmus in another side, considering otolith in ampullary of long arm. The horizontal roll test may restore otolith to utricle and reduce the sensitivity of the diagnostic tests. The result of 10 repetitions were consistent. Conclusion Sixty degree horizontal roll test effectively corrects the defects of 90 degree horizontal roll test. The analysis of diagnostic tests based on the physical engine is of great significance for us to understand the diagnostic mechanism of BPPV in the lateral semicircular canal and to improve and innovate diagnostic maneuver.

Key words: Lateral semicircular canal, Benign positional paroxysmal vertigo, Diagnosis, Otolith, Physical engine, Simulation analysis, Human

中图分类号:

R322.9

杨晓凯. 外半规管良性阵发性位置性眩晕诊断试验分析和物理引擎耳石运动观察[J]. 解剖学报, 2020, 51(2): 245-251.

YANG Xiao-kai. Analysis of the diagnosis maneuver of lateral semicircular canal benign positional paroxysmal vertigo and observation of the otolith movement using physical engine[J]. Acta Anatomica Sinica, 2020, 51(2): 245-251.

参考文献

［1］ Schuknecht HF. Cupulolithiasis［J］. Arch Otolaryngol, 1969, 90(6): 765-778.
［2］ Hall SF, Ruby RR, McClure JA. The mechanics of benign paroxysmal vertigo［J］. J Otolaryngol, 1979, 8(2): 151-158.
［3］ House MG, Honrubia V. Theoretical models for the mechanisms of benign paroxysmal positional vertigo［J］. Audiol Neurotol, 2003, 8(2): 91-99.
［4］ McClure JA. Horizontal canal BPV［J］. J Otolaryngol, 1985, 14(1): 30-35.
［5］ Baloh RW, Yue Q, Jacobson KM, et al. Persistent direction changing positional nystagmus: another variant of benign positional nystagmus ［J］ ? Neurology, 1995, 45(7): 1297-1301.
［6］ Nuti D, Agus G, Barbieri MT, et al. The management of horizontal-canal paroxysmal positional vertigo［J］. Acta Otolaryngol, 1998, 118(4): 455-460.
［7］ Califano L, Vassallo A, Melillo MG, et al. Direction-fixed paroxysmal nystagmus lateral canal benign paroxysmal positioning vertigo (BPPV): another form of lateral canalolithiasis［J］. Acta Otorhinolaryngol Ital, 2013;33(4):254-260.
［8］ Libonati GA. Diagnostic and treatment strategy of lateral semicircular canal canalolithiasis［J］. Acta Otorhinolaryngol Ital, 2005, 25(5): 277-283.
［9］ Pagnini P, Nuti D, Vannucchi P. Benign paroxysmal vertigo of the horizontal canal［J］. ORL, 1989, 51(3): 161-170.
［10］ Kerber KA, Helmchen C. Benign paroxysmal positional vertigo New opportunities but still old challenges［J］. Neurology, 2012, 78(3): 154-156.
［11］ Lu HH, Zhao Y, Chen TSh, et al. Necessity of repeated roll test in horizontal semicircular canalithasis positioned diagnosis［J］. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2016, 51(4): 256-261.(in Chinese)
鲁宏华, 赵媛, 陈太生, 等. 重复滚转试验对水平半规管管石症定位的必要性探讨［J］. 中华耳鼻咽喉头颈外科杂志, 2016, 51(4): 256-261.
［12］ Zhu XJ, Liu Q. Clinical analysis of 35 cases of lateral semicircular canal benign paroxysmal positional vertigo with transformable-direction eye shock［J］. Journal of Otolaryngology and Ophthalmology of Shandong University, 2018, 32(5): 53-57. (in Chinese)
朱梓建, 刘强. 眼震方向可转换型外侧半规管良性阵发性位置性眩晕35 例临床分析［J］. 山东大学耳鼻喉眼学报, 2018, 32(5): 53-57.
［13］ Li X, Wu ShZh, Zheng YY, et al. statistical shape model of the bilateral inner ear［J］. Acta Anatomica Sinica, 2018, 49(6): 736-739. (in Chinese)
李熹,吴曙智,郑炎焱, 等.双侧内耳统计形状模型［J］.解剖学报,2018,49(6):736-739.
［14］ Yang XK, Wu ShZh, Chen XS, et al. 3D visualization of membranous labyrinth from voxel models［J］.Acta Anatomica Sinica, 2017, 48(2): 170-174. (in Chinese)
杨晓凯, 吴曙智, 陈晓素, 等. 基于内耳体素模型的膜迷路三维可视化［J］. 解剖学报, 2017, 48(2): 170-174.

[1]	刘晓丽许琳吴爱雪闻彩云李如画吴安婷陈黛茜陈成春. 多发性硬化和视神经脊髓炎的脑灰质结构分析 [J]. 解剖学报, 2024, 55(1): 17-24.
[2]	白贺滕野冯蕾孟海伟汤煜春刘树伟. 基于空间域与频域特征自适应融合和类间边界区域增强的三维海马分割[J]. 解剖学报, 2024, 55(1): 73-81.
[3]	尹诗琴杨思艺王锐涵游贵宣杨迎秋张磊. 基于CT平扫下胫腓联合腓骨切迹分型及其临床意义[J]. 解剖学报, 2024, 55(1): 82-87.
[4]	杨洋史君李琨马渊张少杰侯二飞王超群陈杰王星李志军 . 切除不同范围钩突后颈椎椎间盘的有限元分析[J]. 解剖学报, 2024, 55(1): 88-97.
[5]	孙雷王星宇谢水华. 老年骨质疏松性胸腰椎压缩性骨折患者PKP术后再发骨折的风险分析及列线图预测模型的构建[J]. 解剖学报, 2024, 55(1): 98-104.
[6]	刘丽平朱梦妮徐慧 . 白细胞介素6对脂多糖诱导所致类子痫前期大鼠有核红细胞的影响 [J]. 解剖学报, 2023, 54(6): 722-729.
[7]	赵卫明李晓余国营王改平常翠芳 . 丝氨酸肽酶抑制因子Kazal型1对肝癌细胞增殖的影响及其机制 [J]. 解剖学报, 2023, 54(6): 695-702.
[8]	袁硕赵安全黄其日麦拉图吴海贺徐永胜齐岩松包呼日查 . 基于下肢全长CT分析胫骨平台后倾角和胫骨扭转角与复发性髌骨脱位的相关性 [J]. 解剖学报, 2023, 54(6): 703-709.
[9]	韩毅蔡力冯枭 . 脊柱骨质疏松性压缩性骨折经皮穿刺椎体成形后骨水泥渗漏风险分析及列线图预测模型的构建 [J]. 解剖学报, 2023, 54(6): 710-715.
[10]	王子善张兴华徐飞宇克莉郑连斌程瑜 . 云南布朗族、德昂族、佤族营养体格指数、肥胖状况及其高血压预警 [J]. 解剖学报, 2023, 54(6): 730-737.
[11]	席焕久李文慧 . 关于人种问题的讨论[J]. 解剖学报, 2023, 54(5): 605-614.
[12]	杜大鹏孙玉张敏王汉琴 . 切应力通过Pim1/Akt调节人脐静脉内皮细胞内皮型一氧化氮合酶Ser633和Ser1177位点磷酸化[J]. 解剖学报, 2023, 54(5): 546-552.
[13]	周春辉谢胜强王姜婷兰晓娟张剑宁赵虎林. 多模态电磁导航辅助新鲜尸头经鼻内镜的颅底解剖测量[J]. 解剖学报, 2023, 54(5): 560-566.
[14]	刘颜静史勇红. 基于FPFH-PointNet的术中膝关节软骨表面点云自动提取[J]. 解剖学报, 2023, 54(5): 553-559.
[15]	白芃李玮钟铧王展飞. 藏族正常成人头颅正中矢状面幕上和幕下面积的磁共振成像测量[J]. 解剖学报, 2023, 54(5): 567-574.

外半规管良性阵发性位置性眩晕诊断试验分析和物理引擎耳石运动观察

Analysis of the diagnosis maneuver of lateral semicircular canal benign positional paroxysmal vertigo and observation of the otolith movement using physical engine

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价