Imai Takao, Takeda Noriaki, Uno Atsuhiko, Morita Masahiro, Koizuka Izumi, Kubo Takeshi
Department of Otolaryngology and Sensory Organ Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
ORL J Otorhinolaryngol Relat Spec. 2002 Nov-Dec;64(6):417-23. doi: 10.1159/000067567.
We have developed a new technique for analyzing the rotation vector of eye movement with an infrared CCD camera [Imai et al.: Acta Otolaryngol 1999;119:24-28]. We used this technique to analyze the eye rotation axis of benign paroxysmal positioning nystagmus (BPPN) that was induced by the Dix-Hallpike maneuver in 14 patients with benign paroxysmal positioning vertigo (BPPV). Eye rotation axes of BPPN in 8 patients were closely perpendicular to the posterior canal of the undermost ear in the provocative head position. Under the hypothesis that BPPN is due to a mechanical stimulation of the posterior canal by canalolithiasis, this finding suggested that the posterior canal of the undermost ear is the lesion. On the other hand, eye rotation axes of BPPN in the other 6 patients were closely aligned with the naso-occipital axis. It is suggested that canalolithiasis induces endolymphatic flow in both posterior and anterior canals via the common crus and the summation of the eye movements induced by stimulation of both the posterior and anterior canals rotates the eye along the naso-occipital axis.
我们开发了一种利用红外电荷耦合器件（CCD）相机分析眼球运动旋转矢量的新技术[今井等人：《耳鼻咽喉科学报》1999年；119：24 - 28]。我们运用该技术对14例良性阵发性位置性眩晕（BPPV）患者在进行Dix - Hallpike手法诱发的良性阵发性位置性眼震（BPPN）的眼球旋转轴进行分析。8例患者的BPPN眼球旋转轴在激发性头部位置时与最下方耳朵的后半规管紧密垂直。在BPPN是由管结石症对后半规管进行机械刺激所致的假设下，这一发现表明最下方耳朵的后半规管是病变部位。另一方面，另外6例患者的BPPN眼球旋转轴与鼻枕轴紧密对齐。提示管结石症通过总脚在后半规管和前半规管中均诱发内淋巴液流动，而后半规管和前半规管受刺激所诱发的眼球运动总和使眼球沿鼻枕轴旋转。
