{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T06:54:36Z","timestamp":1781592876456,"version":"3.54.5"},"reference-count":26,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background and Clinical Significance: Vestibular drop attacks are a rare but disabling manifestation of M\u00e9ni\u00e8re\u2019s disease. This study aimed to demonstrate the value of multimodal audiovestibular assessment in documenting vestibular deficit after intratympanic gentamicin therapy. Case presentation: A 57-year-old woman with refractory Tumarkin crises underwent serial audiological and vestibular testing before and after intratympanic gentamicin treatment. Post-treatment testing demonstrated right-sided vestibular hypofunction with caloric areflexia, reduced vestibulo-ocular reflex gain, corrective saccades on video head impulse testing, and absent cervical vestibular-evoked myogenic potentials. Hearing thresholds showed transient deterioration with near-baseline recovery during follow-up. Vestibular drop attacks resolved completely. Conclusions: Multimodal audiovestibular assessment provides objective documentation of treatment-induced vestibular hypofunction after intratympanic gentamicin therapy in refractory M\u00e9ni\u00e8re\u2019s disease.<\/jats:p>","DOI":"10.3390\/diagnostics16121860","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T05:46:28Z","timestamp":1781588788000},"page":"1860","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Multimodal Audiovestibular Assessment After Intratympanic Gentamicin for Vestibular Drop Attacks in M\u00e9ni\u00e8re\u2019s Disease: A Case Report and Focused Review"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6731-3341","authenticated-orcid":false,"given":"Gabriela Cornelia","family":"Musat","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, Faculty of Dentistry, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 050474\u00a0Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Codrut","family":"Sarafoleanu","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Faculty of Dentistry, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 050474\u00a0Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0172-5962","authenticated-orcid":false,"given":"Mihai Alexandru","family":"Preda","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Faculty of Dentistry, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 050474\u00a0Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreea Alexandra Mihaela","family":"Musat","sequence":"additional","affiliation":[{"name":"Doctoral School, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4475-7737","authenticated-orcid":false,"given":"Ionut","family":"Tanase","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Faculty of Dentistry, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 050474\u00a0Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1001\/archneur.58.7.1151","article-title":"Prosper M\u00e9ni\u00e8re and His Disease","volume":"58","author":"Baloh","year":"2001","journal-title":"Arch. Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1002\/ana.410280314","article-title":"Drop attacks with Meniere\u2019s syndrome","volume":"28","author":"Baloh","year":"1990","journal-title":"Ann. Neurol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1136\/bmj.2.3942.175","article-title":"The otolithic catastrophe: A new syndrome","volume":"2","author":"Tumarkin","year":"1936","journal-title":"BMJ"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1177\/019459988209000221","article-title":"Diagnosis and Management of Drop Attacks of Vestibular Origin: Tumarkin\u2019s Otolithic Crisis","volume":"90","author":"Black","year":"1982","journal-title":"Otolaryngol.\u2013Head Neck Surg."},{"key":"ref_5","first-page":"S1","article-title":"Clinical Practice Guideline: M\u00e9ni\u00e8re\u2019s Disease","volume":"162","author":"Basura","year":"2020","journal-title":"Otolaryngol.\u2013Head Neck Surg."},{"key":"ref_6","first-page":"1","article-title":"Criterios diagn\u00f3sticos de enfermedad de Meni\u00e8re. Documento de consenso de la B\u00e1r\u00e1ny Society, la Japan Society for Equilibrium Research, la European Academy of Otology and Neurotology (EAONO), la American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) y la Korean Balance Society","volume":"67","author":"Carey","year":"2016","journal-title":"Acta Otorrinolaringol. Esp."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Hong, J.-P., Byun, H., and Kim, M.-B. (2025). Low-Dose Intratympanic Gentamicin Injections for Intractable Meniere\u2019s Disease: How Many Are Optimal?. J. Clin. Med., 14.","DOI":"10.3390\/jcm14124342"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"171","DOI":"10.3233\/VES-201514","article-title":"Vestibular drop attacks in M\u00e9ni\u00e8re\u2019s disease: A systematic review and meta-analysis of frequency, correlates and consequences","volume":"32","author":"Kutlubaev","year":"2022","journal-title":"J. Vestib. Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1016\/S0001-6519(05)78650-7","article-title":"Crisis otol\u00edticas de Tumarkin o drop attacks en pacientes con enfermedad de Meniere","volume":"56","year":"2005","journal-title":"Acta Otorrinolaringol. Esp."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1593","DOI":"10.1097\/MAO.0b013e318271c48b","article-title":"Otolithic Membrane Damage in Patients With Endolymphatic Hydrops and Drop Attacks","volume":"33","author":"Calzada","year":"2012","journal-title":"Otol. Neurotol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1080\/00016480701767390","article-title":"Vestibular drop attack secondary to Meniere\u2019s disease results from unstable otolithic function","volume":"128","author":"Ozeki","year":"2008","journal-title":"Acta Otolaryngol."},{"key":"ref_12","first-page":"359","article-title":"Conservative management of Tumarkin\u2019s otolithic crisis","volume":"17","author":"Janzen","year":"1988","journal-title":"J. Otolaryngol."},{"key":"ref_13","first-page":"52","article-title":"Intratympanic gentamicin in M\u00e9ni\u00e8re\u2019s disease: Results of therapy","volume":"18","author":"Murofushi","year":"1997","journal-title":"Am. J. Otol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"27","DOI":"10.3390\/audiolres14010004","article-title":"Vestibular Drop Attack: An Analysis of the Therapeutic Response","volume":"14","author":"Carmona","year":"2023","journal-title":"Audiol. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1007\/s00405-018-5260-5","article-title":"Clinical features and management of Meniere\u2019s disease patients with drop attacks","volume":"276","author":"Wu","year":"2019","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2151","DOI":"10.1002\/lary.24716","article-title":"Intratympanic gentamicin as a treatment for drop attacks in patients with Meniere\u2019s disease","volume":"124","author":"Viana","year":"2014","journal-title":"Laryngoscope"},{"key":"ref_17","first-page":"370","article-title":"Drop attacks and vertical vertigo after transtympanic gentamicin: Diagnosis and management","volume":"25","author":"Dallan","year":"2005","journal-title":"Acta Otorhinolaryngol. Ital."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1080\/000164800454134","article-title":"Round Window Gentamicin \u03bc-Catheter\u2014A New Therapeutic Tool in M\u00e9ni\u00e8re\u2019s Disease","volume":"120","author":"Charabi","year":"2000","journal-title":"Acta Otolaryngol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1007\/s004059900219","article-title":"Preliminary results of a new delivery system for gentamicin to the inner ear in patients with Meniere\u2019s disease","volume":"257","author":"Thomsen","year":"2000","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1080\/00016489.2024.2405004","article-title":"Semicircular canal and vestibular plugging in patients with Meniere\u2019s disease: A preliminary study","volume":"144","author":"Zhang","year":"2024","journal-title":"Acta Otolaryngol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"432","DOI":"10.3390\/audiolres14030036","article-title":"Posterior Semicircular Canal Plugging Relieves Tumarkin\u2019s Crisis in M\u00e9ni\u00e8re\u2019s Disease Patients","volume":"14","author":"Comacchio","year":"2024","journal-title":"Audiol. Res."},{"key":"ref_22","first-page":"11","article-title":"Lateral semicircular canal plugging: A simple and effective surgical treatment against incapacitating Meni\u00e8re\u2019s disease","volume":"129","author":"Gentine","year":"2008","journal-title":"Rev. Laryngol. Otol. Rhinol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.3171\/2021.10.JNS21145","article-title":"Long-term efficacy of vestibular neurotomy in disabling M\u00e9ni\u00e8re\u2019s disease and Tumarkin drop attacks","volume":"137","author":"Brenet","year":"2022","journal-title":"J. Neurosurg."},{"key":"ref_24","first-page":"CD015246","article-title":"Intratympanic gentamicin for M\u00e9ni\u00e8re\u2019s disease","volume":"2023","author":"Webster","year":"2023","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1007\/s10162-007-0093-8","article-title":"Gentamicin is Primarily Localized in Vestibular Type I Hair Cells after Intratympanic Administration","volume":"8","author":"Vogelheim","year":"2007","journal-title":"J. Assoc. Res. Otolaryngol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1080\/14992027.2025.2467769","article-title":"Assessing otolith dysfunction in Meniere\u2019s disease: Insights from multi-frequency vestibular evoked myogenic potential testing","volume":"64","author":"Du","year":"2025","journal-title":"Int. J. Audiol."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/12\/1860\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T06:23:27Z","timestamp":1781591007000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/12\/1860"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,16]]},"references-count":26,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["diagnostics16121860"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16121860","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,16]]}}}