RÉSUMÉ
Tinnitus is very frequent and internal noise that impaires the quality of life. Objective tinnitus, which may be caused by palatal and middle ear myoclonus, is an extremely rare disorder. Such tinnitus may present very rapid, irregular and involuntary vibratory sound. Because it is a very rare disorder and patients have difficulty expressing their symptoms of tinnitus, the examiner may miss the diagnosis unless a careful history taking and physical examination is done. We have experienced a patient with objective tinnitus caused by both palatal myoclonus and middle ear myoclonus, who responded poorly to medical therapy and injection of botulinum toxin. However, this patient is treated with pterygoid hamulus fracture and sectioning of the tensor tympani and stapedial tendons. We report a review of the literature and present a case of a 26-year old man who did not respond to medical treatment and had to be relieved of the symptoms with surgical intervention.