Multimodal Audiovestibular Assessment After Intratympanic Gentamicin for Vestibular Drop Attacks in Ménière’s Disease: A Case Report and Focused Review

Background and Clinical Significance: Vestibular drop attacks are a rare but disabling manifestation of Ménière’s 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 Ménière’s disease.