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Tinnitus has many causes, but it is most commonly related to hearing loss. Unfortunately, the tinnitus percept is generally not affected by conventional or high-bandwidth amplification (=hearing aids), 1 and pharmacological treatment is unsuccessful in the majority of cases. Consequently, tinnitus is notoriously considered to be intractable to any form of treatment, resulting in the appearance of dramatic treatment approaches in the previous century such as prefrontal leucotomies, auditory nerve transsections and the recent development of brain stimulation techniques, in an attempt to reduce the defaitistic adagio: 'you have to learn to live with it'.
There is, however, an almost unknown entity of vascular contact/compression of the vestibulocochlear nerve that can induce a very specific form of tinnitus that is amenable to treatment and therefore important to know. This form of tinnitus has been described in 1993 by Moller et al 2 with clinical manifestations and treatment similar to other vascular compression syndromes such as trigeminal neuralgia, hemifacial spasm, disabling positional vertigo and geniculate neuralgia. Clinically, the...