Tinnitus is a condition where a person (child or adult) hears a buzzing or ringing that is coming from inside their ear. The noise can be either continuous or sporadic, in one or both ears, and high or low in pitch. For some children, the noise can be a roaring, humming, hissing, or clicking sound instead of the typical ringing.
Most children with tinnitus have normal hearing, but it can also be experienced in children who have hearing loss.
Tinnitus is not uncommon in children. About one-third of children experience it at some point, but the condition often goes unnoticed. In some cases, the child is too young to describe what they are hearing, has come to think of it as normal, or is not troubled by the experience enough to mention it.
Although it is rare, more severe cases of tinnitus can cause enough distress that it interferes with sleep and concentration in school.
The possible causes of tinnitus include:
- Noise exposure (cumulative or single (loud) exposure)
- Wax build-up in the ear canal
- Ear or sinus infections
- Misaligned jaw joints
- Neck or head trauma, such as a concussion
- Second-hand smoke exposure
- Medications: chemotherapy, certain antibiotics, aspirin or other medications that can affect the inner ear
- Ear injuries, such as from poking an object too far into the ear
- Acquired hearing loss
- Congenital hearing loss (hearing loss present since birth)
- Differences of the middle ear ossicles (bones)
- Slow-growing tumors on auditory, vestibular or facial nerves
- Ménière's disease
Signs and symptoms
Depending on your child’s age and ability to express themself, as well as the severity of their tinnitus, symptoms may vary and as mentioned, more severe symptoms are uncommon in children. Symptoms may include: Reports of ringing, buzzing, clicking, whistling, humming, hissing, or roaring sound
- Sensitivity to noise
- Poor attention and restlessness
- Increased irritability and/or distractibility
- Problems sleeping
- Anxiety or depression
Testing and diagnosis
If your child is experiencing tinnitus, your primary care provider may refer them to an Otolaryngologist (ear, nose and throat specialist) and /or an Audiologist (hearing healthcare specialist) to have their tinnitus evaluated. These specialists may conduct the following:
- Physical exam and thorough medical history
- Questionnaires/surveys regarding your child’s symptoms and the impact on their daily life
- Hearing test, physiologic tests of middle and inner ear function
Although rare, if there is a concern about the underlying cause of the tinnitus, an otolaryngologist may refer your child for additional testing:
- Lab (blood) tests
- CT scan or MRI
There is no specific treatment for tinnitus. Fortunately, even for children who experience bothersome tinnitus, management strategies can be effective in providing relief. Management may vary depending on whether your child has hearing loss or typical hearing.
In cases where the tinnitus is caused by an underlying condition, your child’s otolaryngologist and/or audiologist will work with you to determine if there are things that can help your child.
- If medication caused the tinnitus, the specialist may recommend a change or discontinuation of medication. In most medication-induced cases, the tinnitus resolves over time.
- If noise exposure caused the tinnitus, your child’s otolaryngologist and/or audiologist will discuss hearing conservation measures and safe listening levels.
- When the tinnitus is caused by hearing loss, hearing technology may be a helpful addition to management strategies. Hearing more environmental sounds helps to make the tinnitus less bothersome.
Whatever the cause of your child’s tinnitus—and especially when the cause is not clear-cut, the goal is management of the condition through the use of different strategies or therapies. These can help to relieve stress and fatigue, which have been known to exacerbate tinnitus. Some strategies/therapies a specialist might recommend for a child include:
- Proper and explanation of their condition: Putting a name to their condition helps to reassure your child that tinnitus is common and that other kids experience the same thing. Having this understanding will greatly reduce their stress.
- Healthy eating, exercise, and a regular sleep schedule: Improving your child’s general well-being can help to decrease stress and fatigue known to aggravate tinnitus. It will also improve their mood, making them better able to cope.
- Healthy hearing education and management: Providing education about the impact of noise (cumulative or sudden) on hearing and when indicated, providing appropriate hearing protection (e.g., custom ear plugs).
- Education about the use of sound therapy, or a sound generator to provide background noise. Using a fan or white-noise machine can blend with the sound of the tinnitus and make it less noticeable. It helps your child to feel in control of their condition, helps their nervous system adapt to the tinnitus, and improves your child’s ability to concentrate. Sound therapy can be especially helpful at night, when many tinnitus sufferers have trouble falling asleep because quiet heightens the tinnitus noises. Some children may also find soft background music to be helpful.
- Cognitive behavioral therapy (CBT): CBT is a practice that focuses on problem-solving to help patients improve their overall sense of well-being. Therapists can help patients determine strategies to help manage stress caused by tinnitus
Fortunately, even for children who experience bothersome tinnitus, management strategies can be effective in providing relief. Children who use some of the management strategies/therapies listed above report improvement in their symptoms. A specialist’s care can help to produce the most successful outcomes, especially in lessening the day-to-day impact of tinnitus.
Why choose CHOP?
Tinnitus can be a distressing condition. The otolaryngologists and audiologists at CHOP are here to help! They will explore all of the options for management of tinnitus, treatment of its underlying cause, and support for your child as they cope with their condition with the goal of improving your child’s quality of life as soon as possible.
Reviewed by Jennifer M. Spellman, MSN, CRNP, CORLN, Sarah McKay, AuD, CCC-A