Dr. Hamid Djalilian and colleagues recently published an article with the American Academy of Otolaryngology–Head and Neck Surgery examining how tinnitus instability or fluctuation may be the most important factor in guiding treatment decisions. Their work suggests that unstable or changing tinnitus can reflect an active dynamic process in the brain that should be addressed to help stabilize symptoms. The article also discusses how these fluctuations may be associated with central sensitization or atypical migraine mechanisms that are often highly treatable.