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 amplitude determines the degree of masking achieved. In some cases, the required masking amplitude is so high as to cause discomfort to the user of the sound generator, and the tinnitus is therefore considered unmaskable. The frequency and other characteristics of tinnitus can vary over time, and the shifts can be temporary or permanent. They may also be cyclical. Therefore the optimal tinnitus mask may need to be adjusted periodically, within days, hours, or even minutes. So a fixed recording (i.e. CD, DVD or audio file) of a tinnitus mask is not a very efficacious application. There are also safety