British Tinnitus Association

David M Baguley, Audiological Scientist Addenbrooke's Hospital, Cambridge
Don McFerran FRCS, Consultant Otolaryngologist Essex County Hospital, Colchester

What is tinnitus?
The word tinnitus describes the sensation of hearing a noise in the absence of an external sound. The noise may be heard in one ear, both ears, in the middle of the head or the patient may find it difficult to describe its exact location. The noise may be low, medium or high pitched. There may be a single noise or two or more components. The noise may be there all the time or it may come and go.

What causes tinnitus?
Tinnitus is not a disease or illness. It is a symptom generated within the person's own auditory pathways. Although it is commonly assumed that tinnitus is a result of disease of the ears, this is not often the case. Tinnitus sufferers have no greater incidence of ear problems than non-sufferers. The precise mechanism by which tinnitus is generated is still not fully understood.

Do children get tinnitus?
Tinnitus is common in all age groups. It is not true that it is confined to the elderly and various studies have shown that it occurs at any age, even in very young children. Children who have had the symptom for a long time may think it is quite normal and therefore not complain about it spontaneously. Some hearing impaired children report tinnitus, if asked about it, but it is rare for this to become a problem.

What is the outlook for children with tinnitus?
Many children with tinnitus seem to eventually lose the symptom. It is unusual to see a child carry the problem into adulthood.

What can be done for a child with tinnitus?
The first step is to arrange a consultation with the child's GP to check the ears and assess the significance of the symptom. If necessary, the GP will arrange a referral to an Ear Nose and Throat (ENT) consultant for further examination and testing. If a specific problem, with the ears is detected appropriate treatment will then be undertaken. However, for the majority of tinnitus patients, no specific medicine or operation exists to cure the problem, for those who need it the next step is multi-pronged therapy for the symptom. In some hospitals this is referred to as Tinnitus Retraining Therapy (TRT). It may be carried out by a doctor, a hearing therapist, an audiological scientist or audiologist. The treatment programme may include some, or all of the following components :

• Reassurance - Many children with tinnitus feel they are the only person to experience it, they are relieved to find they are not alone. They may be worried that there may be a serious underlying reason for the symptom, and appreciate having this excluded.
• Explanation - Many people with tinnitus are perplexed by it and benefit from having the symptom explained. Clearly, a young child may need a simpler explanation than an adult.
• Hope - Many patients, of all age groups, worry that their tinnitus may be permanent and that there is no treatment. This is not the case, the majority of patients improve, though for some progress may be slow.
• Sound generators - Previously known as tinnitus maskers, white noise generators are small, electronic devices that the patient wears. They produce a quiet external sound that allows the patient to concentrate less on the internal tinnitus noise. The devices do not, however, help every tinnitus sufferer.
• Hearing aids - If tinnitus is associated with marked hearing loss, it is often helpful to correct the hearing problem.
• Avoidance of quietness - Most patients with tinnitus notice the symptom is worse in very quiet surroundings. Using an environmental sound generator, may lessen the tinnitus awareness. Sounds used in this way should be enjoyable to the patient and reasonably soft.
• Relaxation - If tinnitus is worsened by stress, such as when taking exams, suitable stress relieving measures may be appropriate.
• Further help - In some cases, specialist clinical help and specifically psychological support may be required.

Summary
The experience of tinnitus is quite common in childhood, but few children become bothered by it in the long term. For those who are troubled, therapy and support is available after seeking an appropriate medical opinion.

December 2008 © British Tinnitus Association

This information is not a substitute for medical advice. You should always see your GP / medical professional