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 wide band white or pink noise, narrow band white noise, a notched soundfield, frequency or amplitude modulated sound, intermittent pulsed sound, or other patterned sound. Temporally patterned sound may be more effective than white noise or background music in masking tinnitus. Studies have found that bandpass maskers are less annoying than pure tone maskers, that the annoyance rating of bandpass maskers is proportional to bandwidth, that intermittent maskers were more annoying than continuous ones, and that control over the center frequency and bandwidth was important in minimizing the annoyance of maskers. In addition to the spectrum of masking sound, the