Corticosteroids are standard treatment for a number of inflammatory and immune-mediated inner ear diseases. In recent years there has been growing interest in intratympanic administration of steroids as a means of achieving high inner ear drug concentration and low risk of systemic side effects. Idiopathic sudden sensorineural hearing loss seems to be the condition with the greatest potential for both study and clinical use of intratympanic steroid treatment. Despite promising preliminary observations, there re-main many unanswered questions about this treatment modality.