title: Tinnitus is prevalent in children with cochlear implants.
abstract: OBJECTIVE
  To explore the prevalence and the perceived impact of tinnitus in children using cochlear implants.
  
  
  METHODS
  Cross-sectional study of implanted children attending a cochlear implant family event organized annually by our academic tertiary pediatric care center. Children were interviewed together with their parents, using open-questioning and structured interview qualitative methodologies. The main outcome measures were the prevalence of tinnitus and any impact of these symptoms.
  
  
  RESULTS
  40 children (age range: 3-15, mean: 7 years) and their families were interviewed. These included unilateral implantees (n=21), and bilateral implantees (n=19) whose two procedures were simultaneous (n=6), within 6-12 months (n=3), or >2 years apart (n=10). Tinnitus was reported by 38% (n=15). Tinnitus occurred most commonly in the implanted ear, when the implants were not in use (e.g. in bed at night). The children were generally untroubled by the tinnitus, although two reported difficulty sleeping. Tinnitus was most frequent in children aged 6-8 years (8/17, 47%), and in bilateral implantees with an inter-procedure delay of at least 2 years (6/10, 60%). Tinnitus was least reported in those implanted bilaterally simultaneously (1/6, 17%), and in those 5 years old or younger (3/11, 27%). No obvious relationship was identified between the prevalence of tinnitus and the etiology of deafness, age of implantation, or time elapsed since implantation.
  
  
  CONCLUSIONS
  To our knowledge this is the first study to report the widespread prevalence of tinnitus in implanted children. Further work, particularly examining the effect of inter-implant delay on tinnitus in bilateral implantees, may contribute to our understanding of the neuronal plasticity after implantation.
authors.affiliation: Department of Otolaryngology, The Hospital for Sick Children, Toronto, Ontario, Canada. neil.chadha@utoronto.ca
authors.forename: Neil K
authors.initials: NK
authors.lastname: Chadha
authors.forename: Karen A
authors.initials: KA
authors.lastname: Gordon
authors.forename: Adrian L
authors.initials: AL
authors.lastname: James
authors.forename: Blake C
authors.initials: BC
authors.lastname: Papsin
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003054:Cochlear Implants / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003638:Deafness / Q000453:epidemiology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D015588:Observer Variation; D010287:Parent-Child Relations; D015995:Prevalence; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014012:Tinnitus / Q000175:diagnosis / Q000453:epidemiology*