Simulation Study of Canal Switching in BPPV

Wu, S. M.; Li, Jianxin; Zhou, Mi; Yang, Xiaokai

doi:10.3389/fneur.2022.944703

Cited by 3 publications

(5 citation statements)

References 16 publications

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“…Here, we performed a physical simulation and analysis of the horizontal semicircular canal diagnostic maneuver based on a previously established BPPV simulation model (15,(18)(19)(20). To facilitate the design of the BPPV diagnostic test, we measured the spatial orientation of the membranous semicircular canal and the crista ampullaris (21).…”

Section: Figurementioning

confidence: 99%

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Design and analysis of HSC-BPPV diagnostic maneuver based on virtual simulation

Yang²

2023

Front. Neurol.

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BackgroundThe preferred supine roll test for the diagnosis of horizontal semicircular canal BPPV has several disadvantages, including difficulty in locating the affected ear, inconsistent nystagmus performance on repeated testing, and lack of a typical latency period, resulting in insensitive diagnosis.ObjectivesTo investigate novel diagnostic techniques with more scientific design, more accessible application, and better diagnostic sensitivity and specificity.Materials and methodsBased on clinical microscopic CT data, we created a virtual simulation model of BPPV using Unity software. The physical simulation of the traditional supine roll test was performed to observe and analyse the movement of the otoliths, whose initial position was the typical stable position. In addition, the normal vectors of the plane and crista ampullaris of the horizontal semicircular canal were measured using 3D Slicer software. Based on this, we analyzed the critical steps for designing diagnostic maneuvers for BPPV in the horizontal semicircular canal. For a more accurate diagnosis of horizontal semicircular canal BPPV, it is critical to rotate the horizontal semicircular canal to be parallel to gravity. It is also necessary to move the otolith by swinging the head. As a result, we developed two diagnostic maneuvers: the 60° roll test and the prone roll test. We also performed simulations to observe otolith movement and predict nystagmus performance.ConclusionsThe 60° roll test and the prone roll test can complement the supine roll test. Compared to the supine roll test, they not only effectively differentiate canalolithiasis from cupulolithiasis, but also make it easier to determine the position of the otoliths, and the characteristics of the nystagmus are more pronounced. Significant diagnostic features have significant potential benefits for home and telemedicine.

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Section: Figurementioning

confidence: 99%

“…The BPPV virtual simulation model is based on Unity 3D software (version 2020.3) and the built-in NVIDIA Physx physics engine developed using browser and server architecture (20). The key steps are as follows:…”

Section: To Build a Bppv Simulation Modelmentioning

confidence: 99%

Design and analysis of HSC-BPPV diagnostic maneuver based on virtual simulation

Yang²

2023

Front. Neurol.

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“…The G-Force swivel chair system (Figure 1) has a high accuracy and stability for nystagmus detection and recording, with spatial and temporal resolution of 640*480@60 Hz (16). The system we have developed also generates a BPPV virtual simulation model based on the patient's nystagmus data and repositioning maneuver parameters, which can be used to visually analyze the movement of the otolith in the semicircular canal (17).…”

Section: Equipmentmentioning

confidence: 99%

Section: Bppv Virtual Simulation Modelmentioning

confidence: 99%

“…A BPPV virtual simulation model was employed to visualize and analyze otolith movement during traditional and modified Epley maneuvers (17). Developed using Unity 3D software (version 2020.3) and the NVIDIA physics engine, the model simulated head movements and postural changes based on maneuver parameters (17). Real patient nystagmus data from the G-Force swivel chair system were used for calibration and validation, generating realistic and dynamic images of otolith movement in the semicircular canal under varying head positions (16,18,19).…”

Section: Bppv Virtual Simulation Modelmentioning

confidence: 99%

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The effectiveness of the modified Epley maneuver for the treatment of posterior semicircular canal benign paroxysmal positional vertigo

Chen,

Mao,

et al. 2023

Front. Neurol.

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ObjectiveTo compare the repositioning effect of the modified Epley maneuver and the traditional Epley maneuver for posterior semicircular canal benign paroxysmal positional vertigo (PC-BPPV).MethodsSixty-five patients with unilateral PC-BPPV were randomly divided into two groups. The control group received the traditional Epley maneuver, while the experimental group received the modified Epley maneuver, which prolonged the time in the healthy side lying position and the final bowing position. The number of successful repositions after one, two, and three attempts and the total number of successful repositions were recorded and compared between the two groups. A BPPV virtual simulation model was used to analyze the mechanism of the modified Epley maneuver.ResultsThe first repositioning success rate of the experimental group was significantly higher than that of the control group (85% vs. 63%, p = 0.040). The experimental group achieved 100% repositioning success rate after two attempts, while the control group needed three attempts to reach 86% repositioning success rate. Four cases in the control group experienced canal switching during the repositioning process, while none in the experimental group did. The BPPV virtual simulation model showed that the modified Epley maneuver could facilitate the passage of otoliths through the posterior arm of the posterior semicircular canal, especially through the location of obstruction.ConclusionThe modified Epley maneuver is more effective than the traditional Epley maneuver in improving the single repositioning success rate and reducing the canal switching rate for PC-BPPV. This study provides a new option for the treatment of BPPV.

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A 3D-Printed Educational Model for First-Line Management of BPPV in Emergency Departments

Canzi,

Carlotto,

Marconi

et al. 2024

Audiology Research

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Background: We present a feasibility study on the development of a 3D-printed (3DP) model of benign paroxysmal positional vertigo (BPPV) and its validation as an educational tool for training in therapeutic maneuvers. Methods: A 1.5:1 3DP model of the human labyrinth, supplemented by a 1:1 3DP model of the skull, was obtained from a computed tomography scan. We presented the model to 15 Emergency Medicine residents, 15 medical students, 15 Otolaryngology residents, and 15 Otolaryngology practitioners from two academic referral centers. Participants performed the Semont and Epley maneuvers on the model twice, once before and once after observing the biomechanics of BPPV using this tool. A specific survey was then administered to assess both performance improvement and satisfaction. Results: All the trainees demonstrated an improving trend on the second attempt. The medical students ameliorated significantly after the training in both Epley (p = 0.007) and Semont maneuvers (p = 0.0134). The Emergency Medicine residents improved significantly in Semont maneuvers (p = 0.0134). Self-reported understanding of the BPPV mechanics improved significantly after training in all the groups (p < 0.05). Conclusions: The preliminary data highlighted the potential benefits of training on the 3DP model for practitioners involved in the first-line management of BPPV.

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Simulation Study of Canal Switching in BPPV

Cited by 3 publications

References 16 publications

Design and analysis of HSC-BPPV diagnostic maneuver based on virtual simulation

Design and analysis of HSC-BPPV diagnostic maneuver based on virtual simulation

The effectiveness of the modified Epley maneuver for the treatment of posterior semicircular canal benign paroxysmal positional vertigo

A 3D-Printed Educational Model for First-Line Management of BPPV in Emergency Departments

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