Tinnitus in children without hearing impairment

Objective: Tinnitus is not an uncommon symptom in the paediatric population and, despite its incidence, is still an unrecognized problem, particularly in normal hearing children. As tinnitus is frequently described by adults without evidence of ear disease, reports of tinnitus can be obtained also from a group of children without otological pathology. The present review has been performed in order to emphasize the great importance to try to identify children suffering from tinnitus and to recognize the difference between the tinnitus characteristics in children with ear pathology and those one without otological problems. Methods: A review of the literature regarding the nature of paediatric tinnitus and the practical diagnostic approach to this symptom has been carried out. Results: Children rarely complain spontaneously of tinnitus but are able to describe itwhen questioned. In our experience the total percentage of children with tinnitus rises from 6.5% (tinnitus reported spontaneously), to 34% when children are specifically questioned. Most children, more than 50%, have normal hearing; in those with hearing impairment, no particular type or severity of hearing loss has been found. An important point that must be considered much more seriously is tinnitus sequela following head injuries to which children are particularly exposed during their daily activities. Due to the serious consequences that may be caused by tinnitus, it is of great importance to identify and analyze it, so as to minimize its damage, utilizing a protocol of study of paediatric tinnitus which allows to collect interesting informations about tinnitus characteristics. Conclusions: In considering that tinnitus in children exists and may provoke serious consequences, even in absence of ear pathology, it is necessary to investigate and understandmore about this symptom in children. From this viewpoint, it is very important to recognize the value of a global evaluation of a child suffering from tinnitus. There is no reason why such an important symptom well reported in adults should not be investigated in the pediatric population in which it seems to be as frequent as in the adult one. It is reasonable to believe that also in children tinnitus may have significant implications for medical and rehabilitative management.