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Go back to the old question of if a tree falls in a forest, does it make a sound if no one hears it?

Tinnitus isn't caused by actual waves of air pressure on the eardrum. We'd not call that tinnitus (unless it was actually inescapable, eg. a perception of rushing blood flow), that's just an annoying real-world sound.

Hearing is connected to eardrum vibrations by a complicated system of the outer ear, eardrum, tiny auditory bones, the fluid-filled cochlea, tiny hair cells with sensory neurons, the auditory nerve, and eventually the brain.

When all these work properly, the brain gets accurate information about sound waves.

When those hair cells are damaged (or wherever the stimulus arises) to send bogus information up the auditory nerve, the audio perceived by the brain as a result of that stimulus is not necessarily correlated to any accurate frequency data that could make it through that pathway.



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