OBJECTIVE To investigate the efficacy of intratympanic dexamethasone injection (IDI) for 23 patients with intractable sudden sensorineural hearing loss (SSNHL). METHODS Dexamethasone (5 g/ml) was injected into the middle ear. The injection was repeated once two days and had a total of 4 doses (10 mg). RESULTS The 23 patients were followed up for one month. Eight of 23 patients (34.8%) demonstrated a 17 to approximately 54 dB improvement in PTA and 15 of 23 (65.2%) had no response. CONCLUSIONS IDI is a simple and effective treatment for SSNHL patient who had not responded to conventional therapy, although hearing was rarely improved to normal levels.