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 retraining therapy since onset, recognition of tinnitus attenuation by sound generator, lower hearing thresholds (i.e. better hearing), high Tinnitus Handicap Inventory (THI) score, and positive attitude toward therapy. Despite the fact that there haven't been any recent studies which concluded in its optimal treatment, tinnitus retraining therapy has been applied to treating hyperacusis, misophonia, and phonophobia. There is no evidence that TRT or any other treatment can eliminate or decrease tinnitus. Tinnitus is a symptom, not a disease. As such, the optimal treatment strategy should be directed toward eliminating the disease, rather than simply alleviating the symptom. More than half of people