Tinnitus is not a disease, and is very rarely a symptom of a serious medical problem. But it can drive people crazy. Michelangelo wrote in his memoirs that he was “plagued by the incessant chirping of crickets.” It may also sound to the sufferer like buzzing, humming or even roaring — but no-one else can hear it. Tinnitus is surprisingly common. A British national study of hearing found that 10% of adults had prolonged spontaneous tinnitus — that is, tinnitus “usually lasting for longer than 5 minutes”; 1% had experienced severe annoyance due to tinnitus; and 0.5% had experienced a severely reduced ability to lead a normal life. Theories about the origins of this internal noise abound; treatments are scarcer. Many doctors will focus “therapy” on reassuring the patient that the problem is not life-threatening. Hopefully this reassurance comes after a thorough medical intake and exam. With a few exceptions, surgery specifically aimed at eliminating tinnitus is obsolete. Before exploring possible treatment strategies, let us consider the two broad categories of tinnitus, and the important “rule-outs” as to the cause...