Abstract
Tinnitus is an auditory sensation perceived by the patient without a corresponding external sound source, which in some cases can profoundly affect the quality of life, causing anxiety or even depression. One of the most demanding areas for tinnitus research is comprehending the underlying pathophysiological mechanisms, particularly for subjective chronic tinnitus. This review provides an update on the main mechanisms involved in the genesis of tinnitus. Cochlear impairment remains an important cause in the onset of tinnitus, especially as it may be present in individuals considered to have normal hearing. These people have alterations on the audiogram that can be seen only at high frequencies, above 8 kHz, undetectable by standard audiometric measurements. Other triggers involved are emotional trauma or neurosensory factors. The feeling of tinnitus reflects a complex interaction between peripheral and central mechanisms at the level of the auditory pathway, but also the involvement of non-auditory central areas, including frontal and parietal lobe or limbic level regions. Considering these aspects, tinnitus can be considered a result of neuroplastic response to sensory deprivation. The knowledge of the complex and multifactorial mechanisms involved in the genesis of tinnitus can guide clinicians to make a correct diagnosis and recommend appropriate therapy in daily medical practice.
Published Version
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