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 efficacy of a tinnitus masker may depend on the wearer's capacity to experience "residual inhibition," the temporary suppression of tinnitus in response to particular sound patterns. The mechanism of sound masking can be explained by analogy with light. In a dark room where someone is turning a lamp on and off, the light will be obviously noticeable. However if the overhead lights are turned on, turning on the lamp will no longer be as distracting because it has been "masked". The concept that an external sound could suppress perception of an internal one was first realised clinically in the mid