Headquartered in Newport Beach, California, Newport‐Mesa Audiology Balance & Ear Institute is one of the country’s largest specialty audiology practices in diagnosis and treatment of vertigo, dizziness, balance disorders and hearing loss. The Institute was established in 1977 by Dr. Howard T. Mango, who is nationally renowned for his ongoing work and research on hearing and balance disorders, establishing him as a leader in vestibular evaluation and treatment. Dr. Mango founded the Institute to address the need for better diagnosis and treatment of acute, undiagnosed or unexplained vertigo, dizziness and balance complaints, as well as hearing loss.
The Institute is leading the country in research, diagnosis and treatment of patients with vertigo, dizziness, balance disorders and hearing loss. The Institute utilizes a proprietary approach to diagnosing and treating vestibular dysfunction called Advanced Vestibular Treatment™ (AVT), which is solely directed by doctors of audiology who only specialize in the vestibular system of the inner ear where the majority of balance disorders originate. Modeled after the U.S. Military, the Institute’s team of specialized doctors of audiology and trained staff utilize highly advanced medical technology to restore vestibular health. Supported by millions invested in diagnostic and treatment technology, the Institute’s exclusive, comprehensive approach has provided effective treatment to more than 50,000 pediatric through geriatric patients. Patients with vertigo and balance deficiencies can be diagnosed and treated in the most cost‐efficient manner possible, eliminating a time consuming, expensive and frustrating course of care experienced by many balance impaired patients. The Institute is also one of the nation’s most well‐equipped audiological facilities, serving an ever‐growing number of adult, teen and pediatric hearing loss cases. The team works closely with neurologists, otolaryngologists, internal medicine and family practice physicians in order to restore balance and hearing to their patients’ lives. The Institute is the only facility of its kind to offer this unique combination of diagnostic and treatment resources.
To achieve a true differential diagnosis and provide the most clinically appropriate treatment, the Institute employs proven methodologies and protocols that combine to provide medicine’s most comprehensive evaluation and treatment. To our knowledge, the Institute is the only facility capable of isolating and testing all ten organs of the inner ear. At the Institute, isolating and evaluating the vestibular system includes some or all of the following tests:
- Comprehensive Diagnostic Audiological Evaluation: Includes video otoscopy, tympanometry, acoustic reflexes with ipsilateral and contralateral presentation, otoacoustic emissions (OAEs), pure tone audiometry, speech recognition thresholds, and word recognition thresholds.
- Vestibular Evoked Myogenic Potential (VEMP): When sound stimulates the saccule, a response travels through the inferior vestibular nerve to the vestibular nucleus in the brainstem. Neural impulses are then relayed through the vestibulospinal tract to the neck muscles. This test provides critical information regarding the integrity of the saccule and inferior vestibular nerve.
- Vestibular Autorotation Testing (VAT): Provides information about the high frequency horizontal and vertical vestibulo‐ocular reflex (VOR); the primary function of the VOR is to stabilize the eyes to allow clear vision during motion, including normal daily life activities such as walking, bending and turning.
- Computerized Dynamic Visual Acuity Test (CDVAT): Provides additional data regarding the VOR function in the horizontal and vertical planes.
- Computerized Dynamic Posturography (CDP): A unique assessment technique used to objectively quantify and differentiate the wide variety of possible sensory, motor, and central adaptive impairments of balance control. CDP can identify and distinguish functional impairments associated with certain pathological processes.
- Videonystagmography (VNG): The VNG is a three‐part evaluation that assesses the inner ear and central functions of the motor system. First is the oculomotor exam which assesses the patient’s eye movements as they follow a moving target. The second part tests patients’ response to various head positions. Last is the caloric test, which independently evaluates (in both ears) the horizontal semicircular canals and parts of the vestibular nerves of each.
- Rotational Chair Examination (RC): The advanced Neuro Kinetics rotational chair is the gold standard for quantifying bilateral vestibular system weakness and independent utricle function. It allows thorough assessment of vestibular compensation, and is used to identify central vestibular system disorders in the presence of a normal caloric testing. It is also the preferred method of pediatric vestibular testing.
- Cochlear Hydrops Analysis Masking Procedure (CHAMP): A modification of the standard auditory brainstem response (ABR) test, CHAMP is used to identify cochlear hydrops or Meniere’s disease. The standard ABR is measured with a click stimulus that activates the entire cochlea. With the CHAMP, the click stimulus is mixed with increasing amounts of high‐pass masking noise. Resulting waveforms provide audiologists with detailed information on basilar membrane response, aiding in accurate differential diagnosis.
- In addition to being one of the nation’s leading dizziness and balance treatment facilities, the Institute is also a respected provider of audiological evaluation services and hearing loss solutions. In fact, the Institute is among the nation’s most well‐equipped audiological facilities, serving an ever‐growing number of adult, teen and pediatric cases. Patients enjoy private, individualized attention from doctors of audiology, who use the latest resources and technologies to help restore hearing.
Mission and Vision
The mission of the Institute is to help patients permanently resolve their hearing, dizziness or balance disorders. The goal is to return patients to the activity levels they experienced prior to the onset of their illness/trouble/trauma. This is accomplished through specialized ongoing training of our doctors of audiology and the most sophisticated diagnostic and treatment technology available. These elements have made the Institute one of the country’s most inclusive balance facilities.
Doctors of Audiology
Howard T. Mango Au.D., Ph.D.
Dr. Mango is founder and Executive Director of the Institute; he received his Bachelor’s and Doctoral degrees from the University of Southern California. He also completed post-graduate work at the University of Virginia and the University of Arizona. Subsequently, he taught at the University of Virginia Medical School. Board‐certified in Audiology, Dr. Mango began private practice in Newport Beach in 1977. He has been a leader in the diagnosis and treatment of vertigo, dizziness and unsteadiness, as well as innovative vestibular rehabilitation techniques for treating benign positional vertigo, migraine and motion sensitivity. He has presented numerous programs across the country in the areas of dizziness and balance disorders, as well as hearing loss and extended‐wear hearing devices.
Jennifer Grace, Au.D.
Our Clinical Director, Dr. Grace, received her Bachelor of Science degree in Speech, Language, and Hearing Sciences from San Diego State University and her Doctoral degree in Audiology at Northwestern University. She joined our Institute initially as a fellow in 2011 and joined our clinical staff after completing her doctoral studies and now manages the Institute’s various clinical treatment programs.
Dr. Grace was drawn to a career in audiology by her drive for scientific knowledge and deep desire to help people. She is a member of the American Academy of Audiology and ASHA and is passionate about implementing cutting edge technology to diagnose, treat and care for patients.
Get to know our entire team of audiologists: www.dizziland.com/about/#team.
Vertigo, Dizziness, Balance Disorders, Hearing Loss and Tinnitus
As many as 35 percent of adults aged 40 years or older in the United States—approximately 69 million Americans—have experienced some form of vestibular dysfunction, such as vertigo, dizziness and imbalance. Eighty percent of people aged 65 years and older have experienced dizziness. One of the leading health concerns for people over the age of 60 is falling. Each year, between 20 and 40 percent of adults over 65 who live at home fall. Older people with chronic dizziness or imbalance are two to three times more likely to fall in comparison with older people who do not experience these problems. The total direct cost of all fall injuries for people 65 and older exceeds $20 billion.
Furthermore, vestibular vertigo accounts for one‐third of dizziness/vertigo symptoms in the medical setting. Benign paroxysmal positional vertigo (BPPV), the most common vestibular disorder, is the cause of approximately 50 percent of dizziness in older people and can be diagnosed and treated successfully with no pills and no surgery. Although 86 percent of people with BPPV undergo medical consultation, interruption of daily activities, or sick leave, only eight percent receive effective treatment. In fact, less than 10 percent of dizzy patients are ever evaluated by a specialist, exacerbating the fact that children with treatable vestibular disorders are sometimes incorrectly diagnosed as learning disabled, dyslexic, or psychologically disturbed. It is estimated that upwards of 50% of children with congenital SNHL (sensorineural hearing loss) also have a vestibular loss or dysfunction. Benign Positional Vertigo (BPV) of childhood, a form of early migraine that is the #1 cause of dizziness in infants and young children between one to four years of age.
One in every 10 (36 million) Americans has hearing loss. As baby boomers age, this number is expected to rapidly climb and nearly double by the year 2030. The prevalence of hearing loss increases with age, up to one in three over age 65. Most hearing losses develop over a period of 25 to 30 years. Among seniors, hearing loss is the third most prevalent, but treatable disabling condition, behind arthritis and hypertension. While the vast majority of Americans (95 percent) with hearing loss could be successfully treated with hearing aids, only 22 percent (6.35 million individuals) currently use them. Only 5 percent of hearing loss in adults can be improved through medical or surgical treatment. Every day in the United States, approximately one in 1,000 newborns (or 33 babies every day) is born profoundly deaf with another two to three out of 1,000 babies born with partial hearing loss, making hearing loss the number one birth defect in America. Only 69 percent of babies are now screened for hearing loss before one month of age (up from only 22 percent in 1998). Of the babies screened, only 56 percent who needed diagnostic evaluations actually received them by three months of age. Moreover, only 53 percent of those diagnosed with hearing loss were enrolled in early intervention programs by six months of age. When children are not identified and do not receive early intervention, special education for a child with hearing loss costs schools an additional $420,000, and has a lifetime cost of approximately $1 million per individual.
Tinnitus is commonly described as a ringing in the ears, but it also can sound like roaring, clicking, hissing, or buzzing. It may be soft or loud, high pitched or low pitched in either one or both ears. In the last year, experts estimate that 22.7 million adult Americans experienced tinnitus for more than three months, which is roughly 10 percent of the adult population of the U.S.
The Most Advanced Diagnostic and Treatment Technology
The Institute has invested millions to equip its diagnostic and treatment team with the latest, most advanced technologies. Today, the Institute utilizes three of only 19 EPLEY Omniax® Systems in the United States to treat difficult‐to‐diagnose vertigo cases, including BPPV. The Institute also utilizes four advanced Neuro Kinetics rotational chairs to diagnose and treat vestibular disorders, following the advanced approach of the United States Military. Additionally, the Institute features Lyric, the first and only 100 percent invisible extended wear hearing device. The Institute is the only facility of its kind to offer this unique combination of diagnostic and treatment resources. This fact, along with ongoing training and specialized expertise of doctors of audiology, distinguish the Institute from virtually all other institutions.
Leading into the Future
The future plans of the Institute are to continue leading the medical industry in evaluation, diagnosis and treatment of vertigo, dizziness, balance disorders and hearing loss. Furthermore, the Institute’s team of doctors of audiology will continue to provide the medical industry with promising diagnostic and treatment information through the advancement of emerging vestibular and auditory research studies.