What you may not know is that tinnitus itself can be considered a sequelae: it is often secondary to other pathologies, such as sensorineural hearing loss; middle ear pathologies such as otitis media, middle ear cholesteatoma, and cerumen and cholesteatoma in the external ear canal; and muscle spasms in the palate or muscle contractions in the middle ear; and tumors near the ear or in the blood vessels of the skull, which can trigger tinnitus. To find out how tinnitus comes about, two tests are required – an audiogram and an MRI of the inner ear canal and inner ear. On the one hand, we can find out how the patient’s hearing is, and on the other hand, we can see if there are any lesions in the inner ear, any problems with the auditory nerve in the inner ear canal, or if there are tumors. We also make a general distinction between tinnitus by its manifestation, which is somewhat related to the sound and rhythm of the tinnitus – for example, high frequency, cicada-like tinnitus that will persist is mostly caused by sensorineural hearing loss. This is also the most common type of tinnitus. Another example is that some patients may feel discomfort in the ear along with tinnitus, with symptoms of pain, running water, and stuffiness, and many have unilateral tinnitus. This is when we consider middle ear pathologies such as otitis media, middle ear cholesteatoma, and cerumen and cholesteatoma in the external ear canal. Tinnitus caused by lesions in the external ear canal and middle ear is more treatable. After surgical removal of the lesions and reconstruction of hearing, most of the tinnitus can be relieved. We have done statistics that 80% of patients with otitis media have their tinnitus relieved after surgery. There are some patients who have fluctuating tinnitus, which sounds like a rhythmic sound to the patient. This type of tinnitus is caused by muscle tremors, which are spasms of the muscles associated with the patient’s palatopharynx, as well as contractions of the muscles in the middle ear. This type of tinnitus is interesting in that it can be heard not only by the patient himself, but also by the person next to him who is close to him. The main treatment for this type of tinnitus is to take medication and relax the spastic muscles. In the case of patients with tumors near the ear and in the blood vessels of the skull, a sound similar to a heartbeat, with a rhythm consistent with a pulse, is also heard. It goes without saying that at this point, once the tumor is resolved, the tinnitus is also improved. There are also patients who have been given a series of examinations, but nothing is found to be wrong, and that is “idiopathic tinnitus”. As the author said earlier, tinnitus is related to our nervousness. The more anxious you are, the more severe the tinnitus will be. In turn, you can’t eat or sleep well, and the tinnitus will get worse. In the past, we thought that we should treat tinnitus until it disappeared. However, according to the current medical level, it is difficult to eliminate a large part of tinnitus completely with surgery or medicine. Therefore, as long as the sound of tinnitus is reduced to a level that does not affect the patient’s life, work or rest, we consider the treatment of tinnitus successful. We consider the treatment of tinnitus successful. This view is especially important for people with idiopathic tinnitus to understand. The elderly are a large part of the tinnitus population. Most tinnitus in the elderly is degenerative, and they tend to have cardiovascular problems that can cause ischemia in the ear, or damage to the ear from noise, toxicity of medications, tobacco and alcohol. This damage is often bilateral and there is hearing loss. After ruling out organic pathology, if the hearing test shows that the elderly person has lost more hearing, we would recommend that he wear a hearing aid – we all have background noise in our ears, and when we lose our hearing, the background noise comes out. When hearing decreases, the background noise comes out. When hearing increases, the background noise decreases. With hearing aids, the tinnitus of many elderly people will be relieved. Lastly, I would like to remind readers that some drug manufacturers claim that “tinnitus will cause deafness” in order to promote their products, which is actually wrong. Tinnitus itself can be considered a sequelae, it does not cause deafness, instead, there is often hearing loss first, then tinnitus. If the tinnitus is followed by deafness, it is because the patient has a hearing problem that leads to deafness.