OBJECTIVE: To investigate the therapeutic efficacy of intratympanic dexamethasone combined with systemic prednisolone in patients with idiopathic sudden sensorineural hearing loss. MATERIAL AND METHOD: From July 2015 to January 2017. A total of 50 eligible patients with ISSNHL were allocated into 2 groups. Patients in the control group were treated with systemic prednisolone alone. Patients of the combined treatment group received additionally 3 intratympanic dexamethasone injections per a week for 3 weeks. Hearing recovery was assessed by pure tone audiogram. RESULT: Significant hearing recovery was observed in 31 (64%) of 25 cases, and in 13 (52%) of 25 control patients.  The total effective rate was 32%and 26% for each treatment protocol, respectively, with statistical significant between them（Ｐ<0.05). Patients receiving combination therapy had a median improvement in PTA of 23.12 dB . In the control group, the median hearing gain was 16.87 dB respectively.  the combined treatment group showed significant improvement compared with the control group (p <0.05). No serious complications or adverse reactions were reported. CONCLUSION: The addition of intratympanic steroids to the conventional systemic steroid therapy may provide a safe and potentially effective therapeutic option in patients with mild–to–severe ISSNHL.  However further multicentre studies are needed to determine the standard protocol.