Tinnitus to the inner ear can cause tinnitus, other apparent causes (e.g., temporomandibular joint dysfunction) are difficult to explain. It may be caused by increased neural activity in the auditory brainstem, where the brain processes sounds, causing some auditory nerve cells to become over-excited. The basis of this theory is that many with tinnitus also have hearing loss. Three reviews of 2016 emphasized the large range and possible combinations of pathologies involved in tinnitus, which in turn result in a great variety of symptoms demanding specifically adapted therapies. Even when tinnitus is the primary complaint, audiological evaluation is usually preceded by
Tinnitus masker in 90% of persons but in rare cases, an hour or more. The period of complete silence is usually seconds to about a minute. If the trigger sound is repeated at intervals, tinnitus can be suppressed as long as the repetition lasts. The residual inhibition (RI) effect first noted in 1903: the capacity of a sound of the right frequency and intensity to briefly attenuate or suppress tinnitus. To distinguish the tailored sound used for inhibition from the broadband undifferentiated sound employed in tinnitus maskers, it is usually referred to as the 'trigger' or 'quieting' sound. The trigger sound is