From the Guidelines
Pediatric tinnitus should be evaluated with a thorough history and physical examination, followed by audiological testing, and management should focus on addressing underlying causes, reassurance, and sound therapy, as it affects approximately 15-40% of children, often without significant long-term impact with proper support 1. The evaluation of pediatric tinnitus should begin with a comprehensive history, including the onset, characteristics of the sound, associated symptoms like hearing loss or dizziness, and potential triggers such as noise exposure or medications. A complete physical examination focusing on the ears, head, and neck should be performed to identify any potential underlying causes.
- Common causes of pediatric tinnitus include:
- Hearing loss
- Ear infections
- Noise exposure
- Head trauma
- Certain medications Audiological testing is essential to assess hearing function and identify any potential hearing-related issues that may be contributing to the tinnitus.
- Management strategies for pediatric tinnitus may include:
- Addressing any underlying cause
- Reassurance and education about tinnitus
- Sound therapy using background noise or music
- Cognitive behavioral therapy for children experiencing significant distress It is crucial to emphasize hearing protection, especially in noisy environments, to prevent further hearing damage and potentially exacerbate the tinnitus.
- Parents should be counseled to:
- Maintain normal activities
- Avoid excessive focus on the symptom
- Recognize that anxiety can worsen tinnitus perception Regular follow-up is essential to monitor symptoms and adjust management strategies as needed, ensuring the best possible outcome for the child 1.
From the Research
Pediatric Tinnitus
- Pediatric tinnitus has not been studied sufficiently to date, and there is no consensus regarding its management in children 2
- Tinnitus counseling can be considered as the most basic tool among therapeutic options for tinnitus in children, with 83.3% of participants showing subjective improvement by tinnitus counseling 2
- Benefit from counseling was significantly associated with age and presence of hearing loss (p=0.037 and p=0.005, respectively) 2
- Cognitive behavioral therapy (CBT) is a collection of psychological treatments based on the cognitive and behavioral traditions in psychology and is often used to treat people suffering from tinnitus, including children 3, 4
- CBT may reduce the impact of tinnitus on quality of life, and may result in little or no difference in adverse effects 4
Management of Pediatric Tinnitus
- Conservative management of tinnitus based on education and counseling instead of medical or surgical treatment should be developed more 2
- Tinnitus retraining therapy and noise generator may be effective in reducing tinnitus symptoms in children with or without hearing loss 2
- Cognitive behavioral therapy is one method to consider for patients with bothersome tinnitus, including children 3
- The effectiveness of CBT versus other treatments, such as notched sound therapy, in adults with chronic subjective tinnitus has been studied, with CBT being more effective in decreasing tinnitus-related distress 5
Treatment Options
- Cognitive behavioral therapy (CBT) is a treatment option for pediatric tinnitus, with evidence suggesting it may reduce the impact of tinnitus on quality of life 4
- Tinnitus retraining therapy and noise generator may be effective in reducing tinnitus symptoms in children with or without hearing loss 2
- Sound therapy and tinnitus retraining therapy are treatment options, but evidence is inconclusive 6
- Melatonin, antidepressants, and cognitive training may help with sleep disturbance, mood disorders, and cognitive impairments, respectively 6