上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.0529-1356.2020.05.011

解剖学报 ›› 2020, Vol. 51 ›› Issue (5): 699-704.doi: 10.16098/j.issn.0529-1356.2020.05.011

上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:2019-04-26 修回日期:2019-07-06 出版日期:2020-10-06 发布日期:2020-10-06
通讯作者: 杨晓凯 E-mail:yakeworld@126.com
基金资助:
浙江省自然科学基金项目;温州市重大科技专项

Analysis the diagnosis maneuver of anterior semicircular canal benign positional paroxysmal vertigo and observation on the otolith movement using physical engine#br#

YANG Xiao-kai*

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

Received:2019-04-26 Revised:2019-07-06 Online:2020-10-06 Published:2020-10-06
Contact: YANG Xiao-kai E-mail:yakeworld@126.com

摘要/Abstract

摘要：

目的对上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。方法建立标准空间坐标系的膜迷路模型，设定膜迷路不同位置结石，基于物理引擎三维物理仿真，分析DixHallpike试验和仰卧悬挂头位试验耳石运动情况，进而推断所诱发眼震表现。结果 Dix-Hallpike试验和仰卧悬挂头位试验所有位置的结石都有一定程度的运动，并能诱发椭圆囊的结石经总管进入半规管。出现下跳眼震的情况，包括结石从椭圆囊进入后半规管，对侧后半规管结石向壶腹运动，上半规管的结石从壶腹嵴帽底部滑动到顶部，后者重复诊断实验仍为下跳眼震。重复10次观察，试验结果一致。结论对于上半规管BPPV的诊断标准，还需要重新评估，观察眼震动态变化是必要的，其诊断方法需要改良。

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

Abstract:

Objective Analysis of the diagnosis maneuver of anterior semicircular canal benign positional paroxysmal vertigo(BPPV) and explore the diagnostic mechanism. Methods The three-dimensional membrane labyrinth model was established in standard space coordinate system, and the otolith in different positions of the membranous labyrinth was set up. The otolith movement in different positions during the Dix-Hallpike maneuver and straight head-hanging test were analyzed based on the physical engine, and the induced nystagmus could be inferred. Results During the Dix-Hallpike maneuver and straight head-hanging test, the otolith in all positions had a certain degree of movement, and it could induce otolith in the utricle to enter the semicircular canal through the common canal. The occurrence of down-beating nystagmus included the otolith enters the posterior semicircular canal from the utricle, the otolith in opposite posterior semicircular canal move towards the ampulla, the otolith in anterior semicircular canal slide from the bottom to the top of the cupula, and the latter still showed downbeating nystagmus in repeated diagnostic tests. The result of 10 repetitions were consistent. Conclusion The diagnostic criteria for anterior BPPV needs to be reassessed. It is necessary to observe the dynamic changes of nystagmus, and the diagnostic maneuver needs to be improved.

Key words: Anterior semicircular canal, Benign positional paroxysmal vertigo, Physical engine, Simulation analysis, Otolith, Membrane labyrinth model, Diagnosis, Human

中图分类号:

R322.9⁺3

杨晓凯. 上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(5): 699-704.

YANG Xiao-kai. Analysis the diagnosis maneuver of anterior semicircular canal benign positional paroxysmal vertigo and observation on the otolith movement using physical engine#br#[J]. Acta Anatomica Sinica, 2020, 51(5): 699-704.

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上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 the diagnosis maneuver of anterior semicircular canal benign positional paroxysmal vertigo and observation on the otolith movement using physical engine#br#

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