Abstract: Objective To compare the efficacy of postauriclar subperiosteal injection of methylprednisolone sodium succinate(methylprednisolone for short)versus intravenous infusion of dexamethasone in the treatment of sudden deafness. Methods A total of 130 patients with low-frequency descending sudden deafness who were admitted to our hospital were selected. According to the random number table method, the patients were divided into observation group and control group, with 65 cases in each group. The two groups were given basic treatment such as improving microcirculation and trophic nerve, and control group was given intravenous infusion of dexamethasone, with a dose of 10 mg per day for the first 3 day, 5 mg per day for the following 7 day, and observation group was given postauriclar subperiosteal injection of methylprednisolone for 20 mg once, and 1 time every two days. After 10 d of treatment, the clinical efficacy, hearing threshold values at different frequencies, relevant biochemical indicators ［serum endothelin(ET), nitric oxide(NO), homocysteine(Hcy)］ and adverse reactions were compared between the two groups. Results After 10 d of treatment, the total effective rate in observation group was significantly higher than that in control group(89.23% vs. 67.69%, P<0.05). The mean hearing threshold values at 250 Hz, 500 Hz and 1 000 Hz in the two groups were significantly lower than those before treatment(P<0.05), and the improvement in observation group was greater than that in control group(P<0.05).The levels of serum ET and Hcy in the two groups were significantly lower than those before treatment while the NO - level showed a significant difference compared with before treatment(P<0.05), and the improvement of ET, Hcy, NO levels in observation group was greater than that in control group(P<0.05). There was no significant difference in the incidence rate of adverse reactions between the two groups(P>0.05). Conclusions Postauriclar subperiosteal injection of methylprednisolone has better clinical efficacy than the intravenous infusion of dexamethasone in patients with sudden deafness. And it has better improvement on hearing threshold value and related biochemical indicators, and it does not increase adverse reactions.