In the past 30 years, the investigation of tinnitus has changed significantly. The early 1950 to 1980, the tinnitus masking therapy was the mainstream method. Then came the tinnitus retraining therapy, used from 1990 to 2000, through explaining the causes of tinnitus and giving patients wide-band noise. After that was cognitive behavior therapy, practiced from 2000 to 2010. Through psychologically counseling, patients can face tinnitus optimistically. After 2015, the treatment strategy made a substantial change. We think that there must be a reason for tinnitus. We started to look for the cause of tinnitus, such as sinusitis, gastroesophageal reflux, sleep apnea syndrome, and even menopausal syndrome. We believe that tinnitus is actually a life-saving alarm. The nasopharyngeal cancer and acoustic neuroma are the most obvious examples. In addition, adjusting the nucleus accumbens of the midbrain, called tinnitus gating control therapy. We help patients get rid of fear, quit drug addictions and improve sleeping quality, plus correcting hearing loss (such as otosclerosis) and Eustachian tube dysfunction. Mostly, in 2018, we proposed that cochlear migraine may be an important cause of fluctuating hearing loss and tinnitus from top-down neuroinflammation mechanism. Cochlear migraine is an important view on tinnitus. Just like vestibular migraine is the greatest imitator of Meniere's disease, cochlear migraine is the wonderful mimicker of sudden deafness. In addition, headache is not a necessary symptom for migrainer, but instead, tinnitus is a common clinical manifestation. We presumed migraine is a unique stress release pathway to the brain. Tinnitus ,vertigo and headache are three major symptoms. We also made progress in pulsatile tinnitus due to sigmoid sinus dehiscence or diverticulum. The r- TMS, neurofeedback, and ketamine therapy are repechages in alternative managements. Lastly, we use the Taiwan's National Health Insurance Research Database (NHIRD) to support our research of the relationship between tinnitus and migraine, sleep apnea, and even sexual dysfunction.