Tinnitus is a common complaint, affecting 10% to 18% of the population.1 It has multiple causes, so further characterization of the tinnitus helps to narrow the differential diagnosis. Some authors advocate division of tinnitus into sound generated by para-auditory sources (usually vascular or myoclonic) and sound originating from the sensorineural auditory system.2 The basis for this division is that there is variance in the examiner's perception of the sound. It is postulated that pulsatile or humming tinnitus is usually of the vascular type regardless of whether it is "objective."2