The most common reasons to give systemic steroids to treat hearing loss are idiopathic sudden hearing loss, severe Meniere's Syndrome and Autoimmune Inner Ear Disease. Generally the steroid is given in a large dose (60 mgm of prednisone per day) tapering down over a relatively short period of time (e.g. 3 weeks). Transtympanic steroids have been used for similar indications but the results have been uneven and this is more controversial. The rational is that they reduce or eliminate an inflammatory or autoimmune reaction. They are most useful at the time of symptoms. When the hearing remains down they may be of some use up to 30 days after onset. With Meniere's or Autoimmune disease the treatment may be repeated if the symptoms recur.