Tinnitus

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What is tinnitus?

Tinnitus is when a person thinks they hear a  sound (e.g. ringing) even though nothing is causing the sound. The types of sounds include ringing, whistling, roaring, clicking, hissing, buzzing and humming.  

The sounds your child hears can:

• be constant, occasional or intermittent
• seem like it is coming from one side or both sides

Children are less likely to mention such sounds because they often think it is normal. In fact, you usually will not know unless you directly ask them, “Are you hearing any sounds right now, like ringing?” 

Tinnitus is very common. It is about as common in children as it is in adults. 

Tinnitus is usually a sign of inner ear damage that causes issues with how you hear. There are many possible causes for tinnitus including: 

• being exposed to loud noises
• permanent hearing loss, congenital or acquired
• conductive hearing loss
• wax build-up in the ear canal
• ear or sinus infections
• ear injuries, such as from poking an object too far into the ear
• abnormal growth of the middle ear bones
• ototoxicity: chemotherapy, certain antibiotics, aspirin or other medications that can damage the inner ear
• second-hand smoke exposure
• anxiety, stress & depression
• hypersensitivity
• TMJ from misaligned jaw joints
• neck or head trauma, such as concussion
• Menière’s disease
• vestibular schwannoma

For many children, the sounds may not cause any distress. Especially if your child is young, they may not know that others cannot hear the sound and may not think about telling you. For some people, the sounds can be distressing and cause problems such as:   

• sensitivity to noise and distress in noisy environments
• difficulty in quiet places where the tinnitus seems "louder"
• difficulty paying attention or listening to others, unexplained listening difficulties
• poor academic performance.
• difficulties with sleep — people might want background noise to fall asleep or may not want to fall asleep or need a quiet bedroom
• irritability and tantrums
• fatigue
• anxiety or depression 

Self-help strategies for tinnitus 

If you think your child has tinnitus, ask them directly if they hear sounds in their ears or head. If they do hear these sounds, the good news is there are lots of things you can do to help ease your child's tinnitus. 

• Reduce exposure to loud noises. For example, move away from loud noise, turn down the volume, or wear hearing protection.
• Live a healthy lifestyle.  Eating a healthy diet, getting regular physical activity outside, and having good sleep hygiene can help reduce stress and tinnitus perception.
• Some people find it helpful to have low-level "white noise"  from a fan, humidifier, air purifier, indoor water fountains, etc. A white noise machine might also be helpful, but you should talk to your hearing professional first. These machines produce background noise such as static or natural sounds like rain, wind or ocean waves. 
• Play low-level background music.
• If your child or youth has problems with stress, consider deep breathing, relaxation or mindfulness exercises.
• If your child has problems with anxiety or depression, consider seeing your primary care provider, or a mental health professional (e.g. counselor, therapist) for help.

Getting help for tinnitus 

If you think your child has tinnitus, start by seeing your primary care provider (e.g. family physician), who will start by looking for medical conditions that might be contributing to tinnitus. Depending on the specific situation, the doctor might recommend other professionals. 

• Audiologist: an audiologist can do hearing tests. Your audiologist can prescribe hearing aids and/or low-level maskers. And can help with Tinnitus Retraining Therapy or sound therapy.
• Otolaryngologist (aka ENT or ear nose throat doctor): an ENT can assess for any treatable ear, nose or throat condition.   
• Psychologist or psychotherapist: can help your child learn techniques to help them cope with tinnitus. 

Tinnitus treatments

If there is an underlying cause for the tinnitus, then treating the underlying cause can help relieve the tinnitus. 

• Is there earwax blockage? If so, then removing earwax may help. 
• Is there a blood vessel condition? If so, then treating the blood vessel condition may help. 
• Is your tinnitus related to hearing loss (age-related or noise-related)? If so, then hearing aids may help.  
• Is your tinnitus related to medications? If so, then adjusting medications may help. 

Medications 

In some cases, medications may be helpful. However, no medicine-based treatments have been approved in Canada to treat tinnitus directly. Speak with your physician about it. 

Tinnitus retraining therapy (TRT)

TRT is a program offered by an audiologist that teaches people how to cope with their tinnitus, consciously and subconsciously. It is a combination of counselling and therapy. It can also be used with other types of treatment like: 

• counselling

• group therapy

• CBT (Cognitive Behavioral Therapy)

The answer depends on the cause behind the tinnitus. It may get better or go away on its own after a certain time. For instance, if your child got tinnitus because of a wax buildup and the wax was removed, the tinnitus could go away in a few days.  In most cases, tinnitus improves as the brain becomes used to the noise.