The most common cause of tinnitus is neurological tinnitus, which may be related to insufficient blood supply to the inner ear and poor microcirculation in the inner ear, and may be related to common causes such as fluid accumulation in the vagus of the inner ear, microthrombosis in the inner ear, vasospasm in the inner ear, and damage to the inner hair cells. 2. Foreign bodies in the ear canal may induce tinnitus, which is commonly associated with cerumen in the ear canal and earworm. 3. Some patients with secretory otitis media, tympanic effusion, or negative pressure in the tympanic chamber induce tinnitus, which is usually a low-pitched tinnitus. 4. Some patients with chronic suppurative otitis media have tinnitus due to the presence of tympanic membrane perforation. 5. 6. Some patients have vascular pulsatile tinnitus, which is the same rhythm as the patient’s heartbeat.