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Treatment of Tinnitus in Children-A Systematic Review
Max J Dullaart1, Marijn Kip1, Adriana L Smit1,2,3
1Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands.
Insights
This systematic review found insufficient evidence to determine the effectiveness of subjective tinnitus treatments in children due to study limitations. More high-quality randomized controlled trials with longer follow-up are needed for pediatric tinnitus management.
Area of Science:
- Otolaryngology
- Pediatric Health
- Evidence-Based Medicine
Background:
- Subjective tinnitus is a common concern in children, impacting their quality of life.
- Current treatment options for pediatric tinnitus lack robust evidence regarding their efficacy.
- Systematic reviews are crucial for synthesizing existing research and identifying evidence gaps.
Conclusions:
- The current evidence is insufficient to determine the effectiveness of subjective tinnitus treatments in children due to significant study limitations.
- Long-term effects of tinnitus therapies in pediatric populations remain unknown.
- High-quality randomized controlled trials with extended follow-up are essential to establish evidence-based guidelines for treating tinnitus in children.
Abstract:
Objectives: To systematically review studies on the effect of treatment of subjective tinnitus in children. Data Sources: We searched for studies in MEDLINE and EMBASE databases, after which additional studies were hand searched using Scopus databases. The methods are described in the study protocol, which has been registered in the PROSPERO register. PRISMA guidelines were followed in the reporting of this study. Eligibility Criteria: We considered for inclusion randomized controlled trials (RCTs), observational studies, case reports, and case series, with tinnitus as primary outcome in children (0-18 years old) with acute or chronic subjective tinnitus. We excluded studies in which both children and adults participated but outcomes were not specifically reported for children, as well as animal studies, studies with a non-original study design and studies about children with pulsatile or objective tinnitus. Data Selection: Two reviewers independently assessed studies for eligibility and quality, collected and extracted data. Statistical analyses were performed in case of homogeneous outcomes. Results: The search yielded a total of 4,447 studies. Of these, 147 eligible studies were selected. One case report and five observational studies met the eligibility criteria. Three studies applied counseling and (simplified-)TRT and reported improvement in tinnitus outcome in 68 out of 82 children after 3-6 months of treatment. Two studies used pharmacological treatments and reported improvement in 74 out of 86 patients after 10 days to 3 months of treatment. One study reported the outcome of biofeedback therapy, describing an improvement in tinnitus loudness and annoyance after 2 months of treatment. Conclusion: Due to the high risk of bias of the included studies, we cannot determine the effectiveness of the treatment of subjective tinnitus in children. Also, owing to brief follow-up periods, it is not possible to draw conclusions regarding long-term effects. Randomized controlled trials with longer follow-up periods are necessary to provide substantial evidence of the effects of therapies for children affected by tinnitus. https://www.crd.york.ac.uk/prospero/ Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, identifier [CRD42020178134].
