Childhood tinnitus: clinical characteristics and treatment

Troublesome tinnitus in children can have an impact on their lives leading to behavioral or psychological problems. The present study was designed to identify the clinical features of childhood tinnitus, to establish the treatment strategy for each tinnitus category and severity, and to assess the treatment outcomes.

Clinical data were retrospectively collected on 108 tinnitus patients in childhood and adolescence. The authors have classified tinnitus according to the acoustic source: otic (idiopathic subjective), myoclonic, and vascular tinnitus based on the tinnitus quality and appropriate diagnostic approaches. Treatment selection depended on the tinnitus category and severity. Treatment modalities included counseling, a simplified tinnitus retraining therapy, counseling with medications, and surgery.

Of all 108 subjects, otic tinnitus was the most common form of childhood tinnitus (n=80) followed by myoclonic (n=21) and vascular tinnitus (n=6). The prevalence of otic tinnitus increased with age. The mean age of myoclonic tinnitus patients was younger than that of the others. The majority of otic tinnitus showed normal hearing. The origin of 81% of myoclonic tinnitus was middle ear muscles. Of all subjects, 67.6% had mild tinnitus responsive to counseling alone. Distressing tinnitus was most common in myoclonic tinnitus. Almost all patients (97%) who were followed up at 3 months (64%) showed improvements.

We suggest that understanding the clinical characteristics of childhood tinnitus, establishing a diagnosis based on the acoustic source, and implementing appropriate therapy customized to the individual tinnitus category and severity would help clinicians to relieve tinnitus children of their troublesome tinnitus effectively.