Balance and Vestibular Program | Research & Innovation

The Boston Children's Balance and Vestibular Program is one of only a handful of vestibular/balance programs specifically dedicated to pediatric patients in the United States. Equipped with the most cutting-edge technologies, clinicians and researchers in our program are continually conducting clinical research and exploring better ways to evaluate and diagnose many forms of childhood balance and vestibular disorders. For anyone who is interested in participating, please contact us for qualification.

Current research projects

  • vestibular function in patients with Usher syndrome
  • otolith function in children with hearing loss due to GJB2 gene/Connexin mutations
  • clinical application of Vestibular Evoked Myogenic Potential (VEMP) testing
  • validation of Subjective Visual Vertical (SVV) test in children
  • vestibular migraine in pediatric population
  • balance and vestibular function status pre- and post-cochlear implantation (CI). In conjunction with the Cochlear Implant Program, we are investigating children’s balance and vestibular functionalities if they are candidates of CI, especially for those with balance concerns.

Multi-specialties Clinic for Children with Post-concussion syndrome

The Balance and Vestibular Program is a partner with the Sports Concussion Clinic. Collaborating with neurologists, ophthalmologists, physical/occupational therapists, and other specialists, our clinicians provide comprehensive assessment of concussed children, particularly for those with protracted dizziness and imbalance. Appropriate therapy and training are offered after evaluation.

Innovation in use of cutting-edge technology

The video head impulse testing (vHIT) is the most recent innovative test of vestibular system. Built on 20 years of research and development by Drs. Halmagyi and Curthoys, vHIT is becoming the new gold standard in evaluating the vestibular function of all three semicircular canals. Although vHIT has been validated for use in adults, its application in pediatric population has not been studied. Our program is a pioneer to use ICS impulse, the first FDA-approved vHIT system, for pediatric patients. Based on our experience of testing more than 100 children, we consider vHIT is the most comfortable and most kid-friendly vestibular test. Our clinical research outcomes on vHIT were presented at a national pediatric otolaryngology conference in 2015.

Publications

Journal articles on pediatric vestibular testing

  1. Zhou G, Dargie J, Dornan B, Whittemore KR. Clinical Uses of Vestibular Evoked Myogenic Potential Testing in Pediatric Patients. Medicine. 2014 July: 93 (4).
  2. Hamilton SS, Zhou G, Brodsky JR. Video Head Impulse Testing (VHIT) in the Pediatric Population. International Journal of Pediatric Otorhinolaryngology 2015;79(8):1283-7.
  3. Brodsky JR, Cusick BA, Kawai K, Kenna MA, Zhou G. Peripheral Vestibular Loss Detected in Pediatric Patients using a Smartphone-based Test of the Subjective Visual Vertical. International Journal of Pediatric Otorhinolaryngology 2015.79(12):2094-8.
  4. Brodsky JR, Cusick BA, Kenna MA, Zhou G. Subjective visual vertical testing in children and adolescents. Laryngoscope 2016; 126(3):727-31.
  5. Zhou G, Goutos C, Lipson S, Brodsky JR. Range of Peak Head Velocity in Video Head Impulse Testing for Pediatric Patients. Otology & Neurotology 2018;39(5):e357-e361.
  6. Brodsky JR and Zhou GW. Perioperative Vestibular Assessment and Testing. Operative Techniques in Otolaryngology 2019. 30(3):162-170.

Journal articles on pediatric dizziness

  1. Brodsky JR, Cusick BA, Zhou G. Vestibular neuritis in children and adolescents: Clinical features and recovery. International Journal of Pediatric Otorhinolaryngology 2016.83:104–108.
  2. Zhou G, Goutos C, Lipson S, Brodsky JR. Clinical Significance of Spontaneous Nystagmus in Pediatric Patients. International Journal of Pediatric Otorhinolaryngology 2018;111:103-107.
  3. Brodsky JR, Lipson S, Bhattacharyya N. Prevalence of Pediatric Dizziness and Imbalance in the United States. Otolaryngol Head Neck Surg. 2020;162(2):241-247
  4. Brodsky JR, Kaur K, Shoshany T, Manganella J, Barrett D, Kawai K, Murray M, Licameli G, Albano V, Stolzer A, Kenna M. Torticollis in children with enlarged vestibular aqueducts. Int J Pediatr Otorhinolaryngol. 2020;131; ePub Ahead of Print.
  5. Wang A, Zhou GW, Lipson S, Kawai K, Corcoran M, Brodsky JR. Multifactorial Characteristics of Pediatric Dizziness and Imbalance. Laryngoscope. 2020; ePub Ahead of Print.
  6. Lipson S, Wang A, Corcoran M, Zhou G, Brodsky JR. Severe motion sickness in infants and children. Eur J Paediatr Neurol. 2020; ePub Ahead of Print.
  7. Rawal R, Zhao X, Lipson S, Brodsky JR. Endoscopic Repair of Traumatic Perilymphatic Fistula in Children: A Case Series. International Journal of Advanced Otology. 2020; ePub Ahead of Print.

Journal articles on vestibular migraine

  1. Brodsky JR, Cusick BA, Zhou G. Evaluation and Management of Vestibular Migraine in Children: Experience from a Pediatric Vestibular Clinic. European Journal of Paediatric Neurology 2016. 20(1):85-92.
  2. Brodsky JR, Kaur K, Shoshany T, Lipson S, Zhou G. Benign Paroxysmal Migraine Variants of Infancy and Childhood: Transitions and Clinical Features. European Journal of Paediatric Neurology 2018;22(4):667-673.

Journal articles on BPPV

  1. Brodsky JR, Lipson S, Wilber J, Zhou G. Benign Paroxysmal Positional Vertigo (BPPV) in Children and Adolescents: Clinical Features and Response to Therapy in 110 Pediatric Patients. Otology & Neurotology 2018;39(3):344-350.
  2. Wang A, Zhou, GW, Kawai K, O’Brien M, Shearer AE, Brodsky JR. Benign Paroxysmal Positional Vertigo in Children and Adolescents with Concussion. Sports Health: A Multidisciplinary Approach. 2020; ePub Ahead of Print.

Journal articles on concussions-related dizziness and imbalance

  1. Zhou G, Brodsky JR. Objective Vestibular Testing of Children with Dizziness and Balance Complaints Following Sports-Related Concussions. Otolaryngology – Head & Neck Surgery 2015;152(6):1133-9.
  2. Brodsky JR, Shoshany TN, Lipson S, Zhou G. Peripheral Vestibular Disorders in Children and Adolescents with Concussion. Otolaryngology – Head and Neck Surgery 2018;159(2):365-370.
  3. Brodsky JR, Choi SS. Best Practice: Should children with an enlarged vestibular aqueduct be restricted from playing contact sports?. The Laryngoscope 2018;128(10):2219-2220.
  4. Shah, AS, Raghuram A, Kaur K; Lipson S; Shoshany T; Stevens R, O’Brien M, Howell D, Fleischman K; Barnack D, Molind H, Kuemmerle KH, Brodsky JR. Specialty-specific Diagnoses in Pediatric Patients with Post-Concussion Syndrome: Experience from a Multi-disciplinary Concussion Clinic. Clinical Journal of Sports Medicine. 2020; ePub Ahead of Print.

Journal articles on cochlear implant-related dizziness and imbalance

  1. Licameli G, Zhou G, Kenna MA. Disturbance of vestibular function attributable to cochlear implantation in children. Laryngoscope. 2009 Apr: 119(4):740-5.
  2. Zhou G, Gopen Q. Cochlear implantation-associated vestibular issues in children. Otorinolaringol. 2009; 59:209-219.
  3. Lipson S, O'Shea R, Gibbons S, Zhou G, Brodsky J. Evolution of Cochlear implant mapping and vestibular function in a pediatric case of Labyrinthitis. J Otolaryngol Head Neck Surg. 2020;49(1):7.