Demographic data, referral patterns and interventions used for children and adolescents with tinnitus and hyperacusis in Denmark.
OBJECTIVE
To investigate whether children and adolescents with tinnitus and/or hyperacusis are seen in Ear-Nose-Throat (ENT) clinics and to report the clinical data, treatment and referral patterns of these children. To describe the population of children and adolescents with tinnitus and/or hyperacusis found in Educational- Psychological Advisory services (EPAs) and Centres for special Education for Adults (CEAs) and to identify the referral patterns and interventions used for the children in each of these settings.


METHODS
A prospective study within 15 ENT clinics was conducted from June 2014 to February 2015. All children with a primary complaint of tinnitus and/or hyperacusis was reported. No changes in daily practice regarding diagnostics, treatment or referral were made. A retrospective case review was undertaken during a five-year period from 01/01/2009 to 31/12/2013 in each Danish municipality and region.


RESULTS
In the prospective ENT study, 12 children were identified and in the retrospective CEA/EPA study 69 children were identified. The 12 children seen by ENT (8 females and 4 male) had an age range from 5.7 to 14 years. The majority of the 69 children seen by CEA/EPA (n = 50, 72.5%) had been diagnosed with tinnitus as a primary complaint. Hyperacusis was the primary complaint in 9 cases (12.8%), and both tinnitus and hyperacusis were reported in 11 cases (15.7%). The findings of this study indicate that a majority of children with tinnitus and/or hyperacusis are seen in settings designed for adult audiological rehabilitation. Counselling, including explanations and discussion of coping strategies was the most commonly reported intervention. Intervention methods corresponding with guidelines for tinnitus management in adults were used in 11 cases (15.9%).


CONCLUSIONS
Overall only a small number of children with tinnitus and/or hyperacusis were identified in this systems, suggesting that either the children are seen at general practitioner level or not being referred at all. It may also be the case that the incidence of troublesome tinnitus in childhood is lower than the epidemiological data proposes. Referral pathways indicate a general uncertainty about which services provide acquire sufficient intervention. This study indicates that clinicians working at tinnitus services for adults (CEAs) collectively have the skills to help older children, and that a service development focus should be on the younger children as this point.
Institute of Regional Health Service Research, University of Southern Denmark, Denmark; Kommunikationscentret, The Social Division in the Capital Region of Denmark, Denmark; Department of Audiology, Odense University Hospital, Odense, Denmark. Electronic address: srosing@health.sdu.dk.
Susanne Nemholt
SN
Rosing
Department of Audiology, Odense University Hospital, Odense, Denmark; Department of Nordic Studies and Linguistics, Copenhagen University, Denmark.
Anestis
A
Kapandais
Department of Audiology, Odense University Hospital, Odense, Denmark; Department of ENT Head and Neck Surgery, Odense University Hospital, Denmark; Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
Jesper Hvass
JH
Schmidt
Audiology Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Department of Vision and Hearing Sciences, Anglia Ruskin University, Cambridge, UK.
David M
DM
Baguley
D000223:Adaptation, Psychological; D000293:Adolescent; D002648:Child; D003710:Demography; D003718:Denmark; D005260:Female; D006801:Humans; D012001:Hyperacusis / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014012:Tinnitus / Q000453:epidemiology / Q000628:therapy*
Adolescents; Children; Hyperacusis; Intervention; Referral; Tinnitus