advancing the diagnosis and treatment of dizziness ......the vestibular diagnostic and...
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Advancing the diagnosis and treatment of dizziness, vertigo and balance disorders.
Newport Beach500 Old Newport Boulevard, Suite 101Newport Beach, CA 92663949.642.7935 Phone949.642.2950 Fax
Ladera Ranch777 Corporate Drive, Suite 130Ladera Ranch, CA 92694949.642.7935 Phone949.642.2950 Fax
dizziland.com
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Renowned for research, diagnosis, treatment and rehabilitation of dizziness, vertigo and balance disorders
Dizziness,vertigoandlossofbalanceareamongtoday’smostfrequently
heardmedicalcomplaints.Andthoughfairlycommon,thesesymptomsoften
pointtoanunderlyingconditionthatifleftuntreatedcanimpactpatients’quality
oflifeandincreasetheirriskoffatalorcripplingfalls.
Newport-MesaAudiologyBalanceandEarInstituteisamongthenation’s
foremostauthoritiesfortheresearch,diagnosis,treatmentandrehabilitationof
vertigo,dizzinessandbalancedisorders.Since1977,founderDr.HowardMango
andhisteamofdoctorsofaudiologyhaveseenandtreatedmorethan30,000
patientsfordizziness,vertigo,balancedisordersandhearingproblems–including
tinnitus,whichmanymistakenlybelievedtobeanuntreatablecondition.
Utilizingthelatesttechnologies
andtechniques,theInstitute’s
highlyskilledexpertspartner
closelywithreferringphysicians
toquicklyidentifyandresolve
patients’ongoingcomplaints.The
Institute’ssimple,single-minded
goalistorestorethebalance
patientsneedtocomfortably
resumetheirdailyactivities.
TheInstituteseekstoenhance
yourindividualizedcare,not
replaceit.Aftersuccessfully
completingtreatment,patients
areimmediatelyreturnedtotheir
referringdoctor,alongwitha
detailedreportandexplanation
oftheirevaluation,therapies
providedandoutcome.
We exist to support you and your practice
Ihadneverfeltsomuchanxietyanduncertaintyaswhenthedizzinessandvertigohitme.ThenIwas
referredtoNewport-MesaAudiologyBalanceandEarInstituteandtheygavememylifeback.
“”
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The vestibular diagnostic and rehabilitation experts
Therearethreecriticalsystemscontinuouslyatplay,helpingmaintain
balanceandequilibrium.Whetherpatientslivenormal,productivelivesdepends
ontheproper,simultaneousfunctionofatleasttwoofthesystems,whichinclude:
Everyyear,alargepercentageof
dizzypatientsgoundiagnosed,
mainlybecausespecialized
resourcesaren’treadilyavailable
tomostdoctors.Asaleader
inthefield,Newport-Mesa
AudiologyBalanceandEar
Institutehasinvestedmillionsto
equipourteamwiththelatest,
mostadvancedtechnologies–
includingtheEPLEYOmniax®
Systemfortreatingdifficult-to-
diagnosevertigocases,including
BPPV.
Wearetheonlyfacilityof
ourkindtoofferthisunique
combinationofdiagnosticand
therapeuticresources.Thisfact,
alongwithongoingtraining
andspecializedexpertiseof
ourdoctorsofaudiology,
distinguishestheInstitutefrom
virtuallyallotherinstitutions.
A multi-million dollar technology investment, now at your disposal
VestibularlabyrinthMinuteinner-earstructures
thatdetectgravity,verticaland
horizontalmotion,andmonitor
rotationofthehead.Becauseofits
complexity,thelabyrinthcanbe
thesourceofchronic,frequently
debilitating,motion-intolerance
andbalancedisorders.
VisualEyestelegraphthebody’s
movementandpositioninspace
tothebrain.
SomatosensoryNervesintheskin,jointsand
musclesthatinformthebrain
aboutbodymovementand
position.
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which patients benefit most from our specialized treatment and care?
Patientswithacute,chronic,undiagnosedorunexplaineddizzinessand
balancecomplaintsmakeexcellentcandidatesforanInstitutereferral.Thosewho
haveundergonenormalelectronystagmography(ENG)orvideonystagmography
(VNG)withoutconclusiveresultsmayalsobenefit,aswellasthosewith:
PhysiciansfrominsideandoutsidetheUnitedStates
entrusttheirhard-to-diagnosedizzinessandbalance
patientstotheInstitute.Ourfast-growingreferral
networkconsistsofawide-ranginggroupofhighly
regardedspecialists,including:
•Otolaryngologists
•Neurologists
• InternistsandFamilyPractionists
•Cardiologists
•Pediatricians
•Neurotologists
National and international referral partner network
• Vertigoordizzinessthatisunresponsiveto
traditionalmedicalmanagement
• BegninParoxysmalPositionalVertigo(BPPV)
• Vestibularmigraineandmigrainevariants
• Motiondisorders
• Gaitorbalancedisordersthatsurfaceduring
neurologicevaluation
• Persistentsymptomsfollowingchemotherapy,
aminoglycosidetherapyorinnerearsurgery
• Sudden,gradualorprogressivehearingloss
• Asymmetricalhearingloss
• Tinnitus
• Hearingaids
• Childrenwithchronicearinfections
andspeechdelay
• Infantswhocannotbetestedusing
conventionalaudiometry
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Proven protocols for diagnosis,treatment and rehabilitation
Toachieveatruedifferentialdiagnosisandrecommendthemostclinically
appropriatetreatment,theInstituteemploysprovenmethodologiesandprotocols
thatcombinetoprovidemedicine’smostcomprehensiveevaluationandtreatment.
Toourknowledgewearetheonlyfacilitycapableofisolatingandtestingallten
organsoftheinnerear.
Comprehensive Diagnostic Audiological EvaluationIncludesvideootoscopy,tympanometry,acousticreflexeswithipsilateralandcontralateralstimulation,otoacousticemissions(OAEs),puretoneaudiometry,speechrecognitionthresholds,andwordrecognitionthresholds.
Vestibular Evoked Myogenic Potential (VEMP)Whensoundstimulatesthesaccule,aresponsetravelsthroughtheinferiorvestibularnervetothevestibularnucleusinthebrainstem.Neuralimpulsesarethenrelayedthroughthevestibulospinaltracttotheneckmuscles.Thistestprovidescriticalinformationregardingtheintegrityofthesacculeandinferiorvestibularnerve.
Vestibular Autorotation Testing (VAT)Providesinformationaboutthehighfrequencyhorizontalandverticalvestibulo-ocularreflex(VOR);theprimaryfunctionoftheVORistostabilizetheeyestoallowclearvisionduringmotion,includingnormaldailylifeactivitiessuchaswalking,bendingandturning.
Computerized Dynamic Visual Acuity Test (CDVAT) ProvidesadditionaldataregardingtheVORfunctioninthehorizontalandverticalplanes.
Computerized Dynamic Posturography (CDP)Auniqueassessmenttechniqueusedtoobjectivelyquantifyanddifferentiatethewidevarietyofpossiblevestibular,sensory,motor,andcentraladaptiveimpairmentsofbalancecontrol.CDPcanidentifyanddistinguishfunctionalimpairmentsassociatedwithcertainpathologicalprocesses.
Videonystagmography (VNG)TheVNGisathree-partevaluationthatassessestheinnerearandcentralfunctionsofthemotorsystem.Firstistheoculomotorexamwhichassessesthepatient’seyemovementsastheyfollowamovingtarget.Thesecondpartteststhepatient’sresponsetovariousheadpositions.Finally,thecalorictestindependentlyevaluatesthehorizontalsemicircularcanalsandthevestibularnerves.
Rotational Chair Examination (RC)TheadvancedNeuroKineticsrotationalchairquantifiesbilateralvestibularsystemweaknessandindependentutriclefunction.Itallowsthoroughassessmentofvestibularcompensation,andisusedtoidentifycentralvestibularsystemdisordersinthepresenceofanormalcalorictesting.Itisalsothepreferredmethodofpediatricvestibulartesting.
Cochlear Hydrops Analysis Masking Procedure (CHAMP)Amodificationofthestandardauditorybrainstemresponse(ABR)test,CHAMPisusedtoidentifycochlearhydropsorMeniere’sdisease.ThestandardABRismeasuredwithaclickstimulusthatactivatestheentirecochlea.WiththeCHAMP,theclickstimulusismixedwithincreasingamountsofhigh-passmaskingnoise.Resultingwaveformsprovidedetailedinformationonbasilarmembraneresponse,aidinginaccuratedifferentialdiagnosis.
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At the Institute, isolating and evaluating the vestibular system includes the following tests:
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Vestibular Rehabilitation Therapy helps return patients to normal activities
IntheUnitedStates,fallsarealeadingcauseoffatalandnonfatalinjuries
inpeopleages65andolder.Thecostoftheseinjuriestofamiliesandtothe
healthcaresystemisenormous.
Tomitigatethisexpense,manyhealthplansclaimtoprovide“fall
prevention”programs.Sadly,however,mostonlyaddressenvironmentalfactors,
suggestingthatpatientscanavoidaccidentsbysimplystoringawaythrowrugs
andinstallinghandrails.
Onetreatmentthathasbeenconsistentlyproveneffectiveintreatingthe
underlyingmedicalcauseofbalanceanddizziness-relatedfallsisVestibular
RehabilitationTherapyorVRT.
Balance and VRT: Teaching the brain to correct itselfVRTisahighlyeffective,customizedtherapeuticapproachfortreatingpatientswithvestibularbalancesystemdisorders.StudiesshowthatindividualizedVRTissignificantlymoreeffectiveinresolvingsymptomsthancommonplacetreatments,suchasmedicationorgeneralbalanceexercises. TheInstitute’sVRTisdesignedasaclinic-directedtherapyapproach,usingcongruenthome-basedexercisesthatarepatientmotivated.Patientstypicallyvisitthecliniconceortwiceaweekforuptosixweeksoruntiltheirstabilityreturns. OurVRTexerciseprotocolstakefulladvantageofthebrain’snaturalplasticityandabilitytorestoresymmetryandincreasesensitivity.Thegoalistoimprovepatients’overallstabilityandmotorcontrolbyenhancingthevestibulo-ocularreflex(VOR)–areflexiveeyemovementthatstabilizesimagesontheretinaduringheadmovement.SuccessfulVRTreturnspatientstomaximumactivitylevelsasquicklyandcomfortablyaspossible.
EPLEY Omniax® System onsite Asaleaderinthediagnosisandrehabilitationofbalanceanddizzinessdisorders,Newport-MesaAudiologyBalanceandEarInstitutecontinuallyaddsleading-edgetestingandtreatmentcapabilities.Today,weareoneofonly15practicesworldwidetofeaturetheEPLEYOmniaxSystem.DevelopedbyneurotologypioneerDr.JohnEpley,theEPLEYOmniaxSystemallowsDr.Mangoandhisteamtocomprehensivelymanageallformsofpositionalvertigo,includingparticleandnon-particlemedicaldisorders,classicBPPVanditsmanyvariants.IntreatingBPPV,theEPLEYOmniaxSystemistheonlywaytoaccessandtreatallsixsemi-circularcanalsin360°ofrotation.ThewidelyusedHallpiketestlooksatonlytwo.The360°rotationenablesusto“gobeyondthetable”tofindandtreatthemostdifficultcasesofvertigoandBPPV.
More personalized, satisfying careForInstitutepatients,advancedcapabilitiesthroughtheEpleyOmniaxSystemtranslateintoseveralclinicalbenefits,including:greatercomfort,shortertreatmenttimesandfaster,moreaccuratetreatments.Advancedpositioningandtreatmentfeaturesprovidetheframeworkforanewlevelofdecisionmakingandanewlevelofcare.
Be our guest on a personal facility tourForamorein-depthdescriptionofInstitutetreatmentprotocolsandtheirbenefits;contactoneofourdoctorsofaudiologyat(949) 642-7935.We’llgladlyanswerallyourquestionsorscheduleapersonalfacilitytour.Youmayalsovisitourwebsiteatwww.dizziland.com.
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Comprehensive diagnosticaudiological evaluation
Inadditiontobeingthenation’sleadingdizzinessandbalancetreatment
facility,Newport-MesaAudiologyBalanceandEarInstituteisalsoarespected
providerofaudiologicalevaluationservicesandhearinglosssolutions.Infact,
we’reamongthenation’smostwell-equippedaudiologicalfacilities,servingan
ever-growingnumberofadult,teenandpediatriccases.Patientsenjoyprivate,
individualizedattentionfromdoctorsofaudiology,whousethelatestresources
andtechnologiestohelpbringpatientsrelief.
TheInstitute’scomprehensive
diagnosticaudiologicalevaluation
includes:
Video Otoscopy
Fordetailedexaminationand
documentationofearcanaland
tympanicmembrane
Audiogram
Computerized,puretone
audiometry,performedina
comfortable,soundproofroomto
preciselymeasurehearingacuity,
speech-recognitionthresholdsand
word-recognitionthresholds
Tympanometry and
Acoustic Reflexes
Accuratelyassessthestatusofthe
tympanicmembrane,Eustachian
tubeandmiddleearossicles
Otoacoustic Emissions (OAE)
Evaluatescochlearouterhair-cell
function
Auditory Brainstem Response
(ABR)
Evaluatestheintegrityofauditory
nervepathway
Hearing loss testing and treatment for adults and teens
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Pediatric hearing lossand balance disorders
A renowned pediatric and newborn testing facilityDespitemandatoryuniversalnewbornhearingscreeningsinnearly40ofthe50UnitedStates,thenumberofchildrenaffectedbypediatrichearinglossisastoundinglyhigh.Atleastonestudyreportsthatalmost15%ofchildrenareaffected.It’struethattheonsetofsomechildhoodhearinglossoccurslater.
Diagnosing and treating childhoodbalance disordersRecentresearchandliterature,aswellasourownclinicalfindings,indicatevestibulardisordersoftengoundetectedamongchildrenandareprominentinthepediatricpopulation.Advancesindiagnosticandtreatmenttechnologynowallowustoeffectivelytreatchildhoodbalancedisorders.
Let us be your resourceNewport-MesaAudiologyBalanceandEarInstituteoffersafullrangeofpediatricandnewborntestingandtreatmentservices.Childrenreceivetheattentionoftwocaringandpatientdoctorsofaudiology. TreatmentsandsupportavailablefromtheInstituteinclude:hearingaids;assistivelisteningdevices,aswellasreferralsforimagingstudies.
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Speech delays, chronic ear infections and other possible causes of hearing loss are also evaluated. Available pediatric services include:
ASSR (Auditory Steady State Responses)TheInstituteisamongonly10%ofalltreatmentfacilitiestopossesstheequipmentnecessaryforthistest.ASSRpredictsauditorythresholdsininfantswhocannotbeevaluatedthroughconventionalaudiometry.
Otoacoustic Emissions (OAE) Assessesthefunctionofcochlearouterhair-cells
Auditory Brainstem Response (ABR)
Evaluatestheintegrityofauditorynervepathway
Newborn hospital screeningsTheInstitutealsoservesasthefollowupfacilityfornewbornswhofailroutinehospitalscreenings.Dr.Mangoandhisseniorstaffpersonallyhandleallinfantcasesandreportfindingsbackdirectlytoreferringpediatricians.
Behavioral Observation Audiometry for infants and young childrenUsingacombinationofvisualreinforcementandconditionedplay,doctorsofaudiologyengagethechildthroughvariousactivities,monitorandassesshearingandsoundlocalization.
Recentstudiesindicatepediatrichearinglossmayaffectasmanyas15%
ofchildren.Itisestimatedthatupwardsof50%ofchildrenwithcongenital
SNHL(sensorineuralhearingloss)alsohaveavestibularlossordysfunction.
BenignPositionalVertigo(BPV)ofchildhood,aformofearlymigraineis
the#1causeofdizzinessininfantsandyoungchildrenbetween1-4yearsof
age.TheInstitute’steamofdoctorsofaudiologyusingthemostadvanced
diagnosticandtreatmenttechnologynowallowsustoaddressthesepediatric
cases,providinginsightandrehabilitationpreviouslyunavailabletoreferring
physiciansandpatients.
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Hearing loss and tinnitus treatments TheInstitute’shearing-losstreatmentoptionsincludeawiderange
oftraditionalandextendedweardevices.Anever-growingselectionof
technologiesisavailable,includingprogrammableanddigitalmodelsthatutilize
computerizedspeechmapping.
Recentstudiesestimatethat10%to15%oftheentireU.S.population
experienceschronicorpersistentringingintheearsorinternalheadnoises
(tinnitus).Twelvemillionhavesymptomsseriousenoughtomeritspecialized
medicalattention.
Yetdespiteitsprevalence,manypatientsandhealthcareprovidersareunaware
thattinnitusistreatable.Thismeansthatalotofpeoplewhocouldbenefitfrom
treatmentarenotyetawareoftheInstitute’sservicesorrecordofclinicalsuccess.
Lyric® extended wear devices
Newport-MesaAudiology
BalanceandEarInstituteuses
theNeuromonics™Tinnitus
Treatment,aclinicallyproven,
six-monthtreatmentprocessthat
helpsalleviatetinnitus.Patented
andFDA-cleared,thisconvenient,
non-invasiveoptionoffers
significant,sometimesimmediate,
long-termreliefwithout
medicationorsurgery.
Supportedbymorethan15
yearsoftinnitusresearchand
clinicalstudies,theNeuromonic
TinnitusTreatmentisconsidered
bymanyexpertstobea
breakthroughinthefield.Because
itaddressesthecondition’s
underlyingcauses,thetreatment
reducessymptomsquickly.In
manypatients,reliefissustained
longaftertreatmentends.
Neuromonics™ Tinnitus Treatment
Dr.Mangoisamongthenation’s
firstpractitionerscertifiedto
prescribeandfitLyric,thefirst
extended-wearhearingdevice.An
invisiblealternativetotraditional
options,thesetinydevicesslip
gentlyandcomfortablyoutof
sight,deepintotheearcanal.
Advancedelectronics
stimulatenaturalhearingand
significantlyreducebackground
noise,offeringsoundfidelitythat
oftenexceedsconventionalaids.
Fullmedicalhistory,earcanal
examinationandaudiological
evaluationdeterminesifthe
patientisacandidateforthe
Lyricdevice.
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Dr. Howard Mango, Au.D., Ph.D. Institute founder
Institutefounderandexecutivedirector,Dr.HowardMango,isavestibular
physiologistandpioneerintheemergingfieldofvestibularrehabilitation.He
andhisteamofdoctorsofaudiologyhavetreatedmorethan30,000patients
sincetheInstitute’sinceptionin1977.
Ourphysicianreferralnetworkconsistsofhighly
respectedOtolaryngologists,Neurologists,Internal
Medicinephysicians,Neurotologists,Cardiologists
andPediatriciansfromtheU.S.andothercountries.
Ifyou’recurrentlyseeingpatientswithundiagnosed
vertigo,dizzinessorbalance-relatedsymptoms,
pleaseletusknow.Wewelcometheopportunityto
supplementyourcarethroughleading-edgediagnostic
andtherapeuticsupport.
Somebenefitsofanaffiliationwithusinclude:
• Bettercarethroughdirectaccesstoadvanced
medicaltechnologyandresources
• Moreaccuratediagnosesandcomprehensivecare
withnocost,riskorinvestment
• Acloseassociationwithanationallyrenowned
diagnosticandrehabilitativefacility
Benefits of referring to the Institute
Evenabrochuretwicethislongwouldn’tfully
conveythebreadthanddepthoftheInstitute’svalue
indiagnosingandrehabilitatingdifficultcases.You
needtoseeifforyourself.
Visitwww.dizziland.comorcall(949) 642-7935
todaytoscheduleapersonalfacilitytourorvisit
fromDr.Mango.Getahands-onintroduction
toourmulti-milliondollarmedical-technology
investment.Andexperiencefirsthandwhysomany
highlyrespectedspecialistsrelyonNewport-Mesa
AudiologyBalanceandEarInstitute.
Diagnosingdizzinessandbalancedisordersmay
sometimesbedifficult,butreturningpatientstotheir
normalactivitiesandlifestylejustbecameeasier.
Request a personal facility tour or educational visit from Dr. Mango