Congratulations on creating this game: it's quite thoughtful and profound. Looking at itch.io, it seems few games have expressed experiences of tinnitus and hearing loss, so this is a really unique authorial voice. The visuals correspond nicely as an allegory to the narrator's distortion of perception.
I think of art games like Dys4ia where the interactive elements of the visual novel enhance and reinforce the meaning of the experience being conveyed. I think you did a good job at integrating those elements into the game.
I am not familiar with neurological tinnitus - I have some from hearing loss - but was very interested in how the narrative does not fixate alone on the physical experience but how tinnitus has psychological impacts.
The prose really elegantly captures the distress of having uncertain sensory input, which carries into the game's feelings of self-doubt, hopelessness and decay. Not sure if these are informed by personal experience but there's enough here to suggest a good literacy of how these things carry lifelong legacies.
In terms of feedback, as you asked - I think the key things that stand out are balancing surrealism with narrative. It can be hard trying to find ways to ground strange or dreamlike sequences - such as the room escape segment - with the earlier flow of the narrative; I interpreted it as a sort of transportative mental break but this wasn't clear.
The player choices at the ending have several paths, with the 'good' ending reconnecting with the motif of the paper cup and learning to live in spite of tinnitus, which I found quite nice. The 'horror' paths are darkly effective too. When players have one choice at the end of a long linear path, they may frame their experience by reference to that ending. It is interesting that two players may ultimately interpret the meaning of this game much differently by the tone that the endings suggest.
Great work. I hope you can continue to create interactive stories like this. It's an incredible medium and you have a good voice for this sort of thing!