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

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。

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

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.