The objective is to investigate and compare the efficacy of intratympanic methylprednisolone or combination therapy as the salvage treatment for idiopathic sudden sensorineural hearing loss （ISSNHL）. Ninety patients with moderate-to-severe to profound SSNHL which were unresponsive to the conventional treatment were recruited. Among these 90 patients, 45 patients underwent intratympanic methylprednisolone therapy （IMT） alone and 45 patients underwent systemic dexamethasone+IMT（systemic steroids+IMT）. IMT was performed every other day, with a total of four times. The pure-tone audiogram （PTA） before and after IMT or systemic steroids+IMT was conducted. And for those with tinnitus or anxiety, tinnitus handicap inventory（THI）, visual analog scale （VAS） as well as Hamilton anxiety rating scale （HAMA） were performed before and after the treatment. The success rate was 31.1% with IMT and 51.1% with systemic steroids+IMT, and the difference was not significant between the two groups. The efficacy of patients with less than 30 days of onset was better than those with more than 30 days, and the difference was not significant, either. Both groups showed significant improvement in the scores of THI, VAS, and HAMA, but no significant difference was found between the two groups. Intratympanic methylprednisolone is recommended as the salvage treatment for patients with moderate-to-severe to profound SSNHL which showed little efficacy after the conventional treatment. Prompt medication improves the therapeutic efficacy.Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.