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.

14 | New PORt-M e SA Au diol og y, B A l A nc e & e A r i ns t i t u t e

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