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

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。

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

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.