LYCOS RETRIEVER 
Tinnitus: Brain
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Tinnitus can ... arise from damage to the nerve between the ear and brain (8th nerve, labeled 6, auditory nerve). Distinct causes are microvascular compression syndrome, viral infections of the 8th nerve, and tumors of the 8th nerve.
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The cochlea is probably the most common site in the origin of tinnitus. The inner and outer hair cells are connected to the central auditory pathway by two systems. Afferent fibers carry information from the inner ear to the central nervous system. Efferent fibers from the brain go to the inner ear. It is felt that abnormalities of the hair cells, efferent or afferent fiber pathways may give rise to tinnitus.
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Usually, patients simply want to know that their tinnitus is not caused by cancer or malignant brain tumor. A skilled counselor can easily provide this reassurance. For most patients, once more serious possibilities are eliminated, counseling suffices. Amplification with hearing aids or other devices may improve subjective tinnitus in more than 50% of patients. Occasionally, the professional services of a psychologist are necessary. The otolaryngologist should be prepared with a teammate who can assist in the care of more complicated tinnitus cases.
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The mechanism that produces tinnitus remains poorly understood. Tinnitus may originate at any location along the auditory pathway from the cochlear nucleus to the auditory cortex. Some leading theories include injured cochlear hair cells that discharge repetitively and stimulate auditory nerve fibers in a continuous cycle, spontaneous activity in individual auditory nerve fibers, hyperactivity of the auditory nuclei in the brain stem, or a reduction in the usual suppressive activity of the central auditory cortex on peripheral auditory nerve activity.4
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Most tinnitus comes from damage to the inner ear (see Figure 1), specifically the cochlea. Tinnitus can ... arise from damage to the nerve between the ear and brain (8th nerve, also called the vestibular nerve); from injury to the brainstem (Lanska et al, 1987); and, rarely, to the brain itself.
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Since there is normally no external sound corresponding to the sounds you are "hearing," tinnitus is truly a phantom sound. Your brain actually detects signals in your auditory system or in its own auditory circuits, and you perceive and "hear" them as real. Make no mistake about it; to you the phantom tinnitus sounds are just as real as any external sounds.
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