Tinnitus emissions (SOAEs), which are faint high-frequency tones that are produced in the inner ear and can be measured in the ear canal with a sensitive microphone, may also cause tinnitus. About 8% of those with SOAEs and tinnitus have SOAE-linked tinnitus, while the percentage of all cases of tinnitus caused by SOAEs is estimated at about 4%. Some people experience a sound that beats in time with their pulse, known as "pulsatile tinnitus" or "vascular tinnitus". Pulsatile tinnitus is usually objective in nature, resulting from altered blood flow, increased blood turbulence near the ear, such as from atherosclerosis or venous
Tinnitus retraining therapy with tinnitus have a comorbid psychological injury or illness (e.g., post-traumatic stress disorder, depression, anxiety, obsessive compulsive disorder, stress, dysfunction of the temporomandibular joint, etc.) that can exacerbate the tinnitus. It has been proposed that tinnitus is caused by mechanisms that generate abnormal neural activity, specifically one mechanism called discordant damage (dysfunction) of outer and inner hair cells of the cochlea. The psychological basis for TRT stems from the fact that the brain exhibits a high level of plasticity. In turn, this allows it to adjust to any sensory signals as long as they do not lead to negative effects.