Aims In the management of idiopathic sudden sensorineural hearing loss, intratympanic therapy delivers high local drug concentrations with fewer systemic effects, but the optimal dosage for hearing recovery remains unclear. This systematic review evaluates evidence on intratympanic corticosteroid dosing in adults with idiopathic SSNHL, assessing whether higher concentrations improve hearing outcomes and the quality of current studies. Methodology A systematic review of PubMed, MEDLINE, Embase, and Google Scholar was conducted. Studies were included if they involved adult patients with idiopathic SSNHL, used intratympanic corticosteroids as primary or salvage therapy, and reported objective hearing outcomes such as pure-tone audiometry. Studies not comparing dosages or using continuous steroid infusion were excluded. Screening and data extraction were performed independently by two reviewers. Results were synthesised according to Cochrane Synthesis Without Meta-analysis (SWiM) guidelines. Results Four studies met inclusion criteria, all evaluating intratympanic dexamethasone with a total patient population of 325 patients. There were no studies comparing doses of methylprednisolone. Two studies reported significantly greater hearing gains with higher doses, while two, including one randomized controlled trial (RCT), showed no significant difference. Heterogeneity in dosing regimens, co-interventions, number of injections and timing of treatment precluded meta-analysis. Risk of bias was moderate for observational studies and low for the RCT. Conclusion Current evidence is limited and inconsistent regarding the optimal intratympanic corticosteroid dose in SSNHL. While some studies suggest higher dexamethasone doses may improve hearing outcomes, methodological heterogeneity and moderate risk of bias prevent definitive conclusions. Further high-quality, dose-comparison RCTs are required to establish clinically meaningful dosing recommendations and guide safe, effective treatment strategies.