Etiopatogeneza tinitusului – o enigmă încă pentru medicină

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.