Wu Shuzhi, Li Jianxin, Zhou Mi, Yang Xiaokai
Neurology Department, Third Affiliated Hospital of Shanghai University, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, China.
Third Affiliated Hospital of Shanghai University, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, China.
Front Neurol. 2022 Jul 13;13:944703. doi: 10.3389/fneur.2022.944703. eCollection 2022.
The objective of this research was to investigate the mechanism of canal switching in benign paroxysmal positional vertigo through a virtual simulation model. Using Unity 3D software and a built-in NVIDIA Physx physics engine, the virtual simulation software is developed using a browser-server architecture, and different models are imported. Based on the benign paroxysmal positional vertigo virtual simulation model, we constructed five different virtual reality scenes of diagnosis and treatment, set otoliths in different positions of the semicircular canals, and analyzed the effects of diagnostic and therapeutic procedures on otolith location. Through the analysis of otolith movement in five virtual scenes, we found that canal switching may be caused by otoliths in the utricle entering the semicircular canal in the supine position. Then, we used different methods to reposition the otolith, improved the repositioning maneuver, and explored in depth the mechanism of the canal switching. The results showed that the main reason for the canal switch is that in the supine position, the otolith in the utricle enters the semicircular canal. The repositioning maneuvers, including the Epley maneuver and Barbecue maneuver, will not directly lead to the canal switch in the ipsilateral inner ear. The supine roll maneuver leads to the otolith in the utricle entering the posterior or lateral semicircular canal, which is the most likely mechanism for canal switching.
本研究的目的是通过虚拟模拟模型探究良性阵发性位置性眩晕中半规管转换的机制。利用Unity 3D软件和内置的NVIDIA Physx物理引擎，采用浏览器-服务器架构开发虚拟模拟软件，并导入不同模型。基于良性阵发性位置性眩晕虚拟模拟模型，构建了五个不同的虚拟现实诊疗场景，在半规管的不同位置设置耳石，并分析诊疗程序对耳石位置的影响。通过对五个虚拟场景中耳石运动的分析，我们发现半规管转换可能是由于仰卧位时椭圆囊中的耳石进入半规管所致。然后，我们采用不同方法重新定位耳石，改进复位手法，并深入探究半规管转换的机制。结果表明，半规管转换的主要原因是仰卧位时椭圆囊中的耳石进入半规管。包括Epley手法和烧烤手法在内的复位手法不会直接导致同侧内耳的半规管转换。仰卧翻身手法会导致椭圆囊中的耳石进入后半规管或外半规管，这是半规管转换最可能的机制。
