Objective To observe the therapeutic effect of three pathway hormone therapy on sudden deafness with total deafness.Methods 96 patients with sudden sensorineural hearing loss from January 2020 to December 2022 were selected and randomly divided into an observation group and a control group.The control group received intravenous dexamethasone infusion and conventional treatment.On this basis,the observation group received additional injections of dexamethasone in the tympanic cavity and behind the ear for a total of 10 days of treatment.Results 22 patients in the control group showed improvement in hearing,with an effective rate of 45.83%,while 30 patients in the observation group showed improvement,with an effective rate of 62.50% .The mean pure tone hearing thresholds of the control group and the observation group before treatment were(95.3±13.2)dB HL and(96.1±13.1)dB HL,respectively.After the treatment,they were(63.2±17.1)dB HL and(52.8±16.8)dB HL,respectively.The treatment effect of the observation group was better than that of the control group(P<0.05).There was no statistically significant difference in the improvement rate of symptoms such as tinnitus,dizziness,and ear tightness between the two groups(P>0.05).Conclusion Early three pathway hormone therapy for sudden deafness can effectively improve hearing recovery and is worthy of clinical promotion.