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. 2016 Mar 19;2(1):1-6.
doi: 10.1016/j.wjorl.2016.02.002. eCollection 2016 Mar.

A 3D benign paroxysmal positional vertigo model for study of otolith disease

Michael Teixido  1 , Owen Woods  2 , Brian Kung  3 , Mohammad Seyyedi  1
Affiliations

A 3D benign paroxysmal positional vertigo model for study of otolith disease

Michael Teixido et al. World J Otorhinolaryngol Head Neck Surg. .

Abstract

Objective: To develop a three-dimensional study tool of the membranous labyrinth in order to study the pathophysiology, diagnostic workup and treatment of benign paroxysmal positional vertigo (BPPV). BPPV is the most common cause of peripheral vertigo. Its diagnosis and treatment depend on an understanding of the anatomy of the vestibular labyrinth and its position relative to the head. To date, many illustrations have been made to explain principals of diagnosis and treatment of BPPV, but few have been based on anatomical studies of the membranous labyrinth.

Methods: A cadaveric human membranous labyrinth was axially sectioned at 20 μm resolution, stained and segmented to create a high-resolution digital model. The model was cloned to create an enantiomeric pair of labyrinths. These were associated a 3D model of a human skull, segmented from MRI data, and were oriented according to established anatomic norms. Canal markers representing otoliths were created to mark canalith position during movement of the model within the 3D environment.

Results: The model allows visualization of true membranous labyrinth anatomy in both ears simultaneously. The dependent portion of each semicircular duct and of the utricle can easily be visualized in any head position. Moveable markers can mark the expected progress of otolith debris with changes in head position and images can be captured to document simulations. The model can be used to simulate pathology as well as diagnostic maneuvers and treatment procedures used for BPPV. The model has great potential as a teaching tool.

Conclusion: A simple model based on human anatomy has been created to allow careful study of BPPV pathophysiology and treatment. Going forward, this tool could offer insights that may lead to more accurate diagnosis and treatment of BPPV.

Keywords: 3D; Anatomy; Benign paroxysmal positional vertigo; Histology; Model; Modeling.

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Figures

Fig. 1
Fig. 1
Final smoothing and editing of the model and addition of colors to each of the canals was done using 3DSMax Software (Autodesk Inc. San Rafael, CA).
Fig. 2
Fig. 2
(A) Cloned labyrinths associated with skull model extracted from MRI data. (B) Addition of skin surface to the model and demonstration of anterior to anterior canal angle of 104°. (C) Demonstration of posterior canal to posterior canal angle of 83°. (D) Demonstration of horizontal canal to horizontal canal angle of 155°.
Fig. 3
Fig. 3
Canal markers indicating the expected position of an otolith mass in any position can be moved to any position on the labyrinth.
Fig. 4
Fig. 4
Desktop view of the Amira viewer with the model in the working environment.
Fig. 5
Fig. 5
(A) Right superior canalithiasis after left Dix-Hallpike demonstrating the angle below horizontal needed to provoke otolith movement. (B) The final expected position of the otolith mass.
Fig. 6
Fig. 6
The otolith marker is shown within the membranous labyrinth at the nonampullated end of the right horizontal semicircular canal.
See this image and copyright information in PMC

References

    1. Dix M.R., Hallpike C.S. The pathology symptomatology and diagnosis of certain common disorders of the vestibular system. Proc R Soc Med. 1952;45:341–354. - PMC - PubMed
    1. Schuknecht H.F. Cupulolithiasis Arch Otolaryngol. 1969;90:765–778. - PubMed
    1. Epley J.M. The canalith repositioning procedure: for treatment of benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg. 1992;107:399–404. - PubMed
    1. Hashimoto S., Naganuma H., Tokumasu K., Itoh A., Okamoto M. Three-dimensional reconstruction of the human semicircular canals and measurement of each membranous canal plane defined by Reid's stereotactic coordinates. Ann Otol Rhinol Laryngol. 2005;114:934–938. - PubMed
    1. Siebenmann F. Bergmann; Wiesbaden: 1890. Die Korrosions-Anatomie des knˆchernen Labyrinthes des menschlichen ohres.