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Originally published Sunday, July 25, 2010 at 7:02 PM

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Dr. Dizzy's chair may set vertigo suffers straight

The rotational chair may look an amusement-park ride, but it's actually a sophisticated, $250,000 tool in the diagnosis and treatment of vertigo and other balance disorders.

The Orange County Register

NEWPORT BEACH, Calif. — The chair starts spinning.

And as it spins, a little boy, Casey, age 3, wearing some very cool goggles, watches lights that seem to travel with him as he sits and twirls in a darkened chamber atop his mother's lap.

Heidi Brandl has a routine to keep her son engaged during these 45-minute therapy sessions. When the "disco ball light" goes on, projecting hundreds of pinpoints of light on the wall, they name and "shoot" the stars.

"You're like a space commander!" Brandl tells Casey.

The rotational chair may look an amusement-park ride, but it's actually a sophisticated, $250,000 tool in the diagnosis and treatment of vertigo and other balance disorders.

And the weekly spins are keeping Casey from bumping into walls or habitually falling and bruising his tiny body — behavior that, until recently, confounded his parents.

The chair is one of two state-of-the-art machines at the offices of a veteran Newport Beach, Calif., doctor of audiology who, when he's not treating patients, is belting out show tunes as a longtime community stage actor.

Whatever role he's playing, one thing's for sure about Dr. Howard T. Mango: The role better be new and it better be big — or it's not worth playing.

"If I had to do the same thing, every day, for the past 35 years, I think I would have shot myself a long time ago."

Grasping the finer details of the treatment that Mango and his colleagues perform at Newport Mesa Audiology Balance and Ear Institute is enough to make an outsider feel, well, dizzy.

It's easier to wonder how Mango became a hearing specialist. He grew up in New York and attended a few ear-splitting cultural milestones — the Beatles concert at Shea Stadium and, later, Woodstock.

Could there be a connection?

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Whatever the case, Mango — that's not a stage name, folks — has made a name for himself as a pioneer in treating hearing and balance disorders. When he purchased a private audiology practice in Newport Beach in 1977 he became one of the first such specialists in the country.

And, while no one keeps track of audiologists who have tackled roles like Nathan Detroit in "Guys and Dolls," it's a good bet Mango's in select company there still.

Extreme dizziness

Born full term, Casey Ecker (his mother uses her maiden name) was late hitting certain growth milestones like rolling over, sitting up and crawling. His speech also was delayed. When he wasn't walking at 18 months, his parents consulted a pediatrician.

It wasn't until this February, however, when he was referred to Mango's office, that Casey was diagnosed with peripheral vestibular dysfunction.

The disorder won't curtail his mental development, and it won't require medication to be treated. But Casey's peripheral vestibular dysfunction was, and is, an extreme case of dizziness.

A physician in Mango's office, Dr. Cara Makuta, has been treating the boy ever since the diagnosis, talking to Casey through a headset as he spins in the chair, and blowing bubbles with him after each session.

The rotational chair Casey uses to improve his balance has impressed top brass at Camp Pendleton. Physicians at the base are in the process of installing the machine to treat mild traumatic brain injuries suffered by troops returning from combat.

The showcase machine in Mango's office, however, is a contraption called the Epley Omniax — one of only 14 in the world, according to Mango.

He fired up the machine in December.

With the slightly giddy enthusiasm of a Tech geek, Mango showed off its features.

The Epley chair is capable of moving a patient through 360 degrees in any plane and in any position relative to gravity — such as upside down.

While moving the patient in different positions, Mango monitors eye movements. This allows him to pinpoint which area of the inner ear is causing dizziness, and then treat the problem by moving the patient in a different position.

Mango characterizes the Epley chair as a milestone in technology that allows for the diagnosis and treatment of vertigo without surgery or medication.

"As recently as five years ago, we still were missing pieces of the puzzle," Mango says.

The Epley chair does automatically what Mango and other specialists have been doing for years to treat positional vertigo: maneuvering patients by hand on a table.

Relief for patient and parent

According to medical literature, dizziness and vertigo are common problems, but fewer than 10 percent of dizzy patients are ever evaluated by a specialist like Mango.

Brandl says Casey was functioning at about 20 percent overall when he started therapy, and now is at about 65 percent. Sessions in the chair help him retrain his system, Makuta said.

"I would constantly tighten my stomach when Casey approached stairs or uneven areas, where he had a good chance of falling and hurting himself," Brandl says. "Since therapy, I no longer have that tightened stomach feeling."

Mango, 58, isn't sure what's next on his acting platter. He's pretty busy running a medical practice and being a father to a 6-year-old son.

"I married late," he says.

Meanwhile, his lifetime patient roster has ticked past 30,000 — all visitors to "Dizziland," as Mango refers to his practice in online (www.dizziland.com).

He watches Brandl hold Casey as they both strap into the rotational chair.

Then he hears her say a line that may or may not have come out of his mouth somewhere, on some stage under the bright lights:

"Wanna go for a spin, boo-boo?"

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