Do musical hallucinations always arise from the inner ear?

It has been known for some time that musical hallucinations occur in deaf patients. This has been ignored, as it has been believed that neurological and psychiatric causes predominate. However, despite specific appeals, no one with musical hallucinations and a lesion in the brain but not in the ear has been produced. The postulated otological basis is a hyperactive state of the ear, a slight endolymphatic hydrops or pre-Meniere's disease. The hallucinations probably develop out of rhythmic tinnitus. A review of all the very disparate states and diseases supposedly causing musical hallucinations shows that peripheral ear symptoms are always present. It therefore seems that they always have the same simple otological trigger.