Tinnitus in Children - Still a Neglected Problem.
In general, pediatric tinnitus and head trauma, induce tinnitus in children, in particular, which are a neglected problem in Ear, Nose, and Throat and pediatric medicine. A case report and the pertinent literature demonstrating this issue are presented. It is recommended to perform controlled studies regarding pediatric tinnitus in order to identify, and treat it, so as to minimize its damage. Subjective tinnitus which is often reported as being very disturbing is rarely mentioned in the pediatric population.(l) Nodar(2) mentioned in his literature review of 11 years, that he found only two publications dealing with tinnitus in children. This fact is even more amazing as tinnitus is not uncommon in the pediatric population; 13%(3) to 29%(4) of normal hearing children and 59% of children who had their hearing screened at school(3) complained of tinnitus. Tinnitus was reported in 66% of children with moderate to severe deafness and in 29% of deaf children.(5) Out of those with moderate to severe deafness, 30% complained of a very disturbing tinnitus (every day in frequency, of at least 30 minutes duration and grade III out of three severity degrees of loudness). Although tinnitus in children is as common as in the adult population, children generally do not complain spontaneously of having tinnitus.(5) Out of 403 children with tinnitus only 3% complained spontaneously.(4) This discrepancy between the high incidence of tinnitus and low rate of spontaneous complaint in children may be explained by the fact that the child considers tinnitus to be a normal event, as it has usually been present for a long period of time.(6) A second explanation of this discrepancy lies in the fact that the child may not distinguish between the psychological impact of the tinnitus and its medical significance.(6) Even if a child does not mention the existence of tinnitus, nevertheless, it may cause difficulties in concentration and bring about behavioral problems.(5) Pediatric tinnitus, despite its incidence and behavioral sequela, has not received adequate consideration in the otolaryngological and pediatric literature; furthermore, there is complete disregard concerning the post traumatic tinnitus in children. There is no reason why such an important etiologic factor reported in the adult population(7,8) would not be present in the pediatric population, in which head trauma is, at least, as frequent as in the adult one.
Ben-David
J
Department of Otolaryngology - Head and Neck Surgery, Bnai Zion Medical Center, The Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
Podoshin
L
Fradis
M