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Topics In Audiology > 5) Tinnitus in Children > Flashcards

5) Tinnitus in Children Flashcards

1
Q

Tinnitus in children is often overlooked due to what 3 things?

A

̶1) Their difficulty in articulating symptoms.
̶2) Children may perceive tinnitus as normal or trivial, leading to underreporting.
̶3) Challenges in assessment and management of tinnitus in children vs. adults

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2
Q

What is the tinnitus prevalence in children with normal hearing?

A

4.7% to 46%

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3
Q

What is the tinnitus prevalence in children with hearing loss?

A

23.5% to 62.2%

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4
Q

Why is there a wide prevalence range when it comes to tinnitus in children?

A

The wide tinnitus prevalence range highlights inconsistency in evidence, due to studies’ diversity in research methods.

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5
Q

What is the prevalence of hyperacusis in children?

A

3.2% to 17.1%.

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6
Q

̶Reasons for inconsistency in tinnitus prevalence: Studies are diverse in (5):

A

̶- Research design
̶- Characteristics of the study population (age, auditory disorders, underlying diseases)
̶- Tinnitus definition (permanent and/or intermittent)
̶- Tools (objective or subjective: psychoacoustic assessments, interviews, questionnaires)
̶- Interview with parents or children

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7
Q

Prevalence data in children rely on ____

A

parental questionnaires

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8
Q

The etiology of tinnitus in children can be ____ or ____

A

congenital (familial), acquired

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9
Q

What are the 7 etiologies of acquired tinnitus?

A

1) Middle ear infections
2) Pulsatile middle ear tinnitus
3) Non-pulsative middle ear tinnitus
4) Temporomandibular joint disorder
5) Intracranial tumors
6) Hydrocephalus
7) SNHL for any reason

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10
Q

Explain pulsatile middle ear tinnitus (4)

A

̶- Venous hums (hearing the normal flow of blood through the jugular veins.)
̶- Transmitted bruits over the carotid artery
̶- Glomus tumors (benign but invasive tumors arising from glomus cells)
- The above 3 are synchronized with the heartbeat
̶- Middle ear myoclonus sound

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11
Q

Explain non-pulsatile middle ear tinnitus

A

̶- Patulous Eustachian tube involvement (The valve of the Eustachian tube remains abnormally open)
̶- Tympanic membrane perforation

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12
Q

All 3 etiologies of acquired tinnitus are ____

A

somatosounds

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13
Q

What are somatosounds?

A

Noises that originate within the body. They are not directly connected to the auditory nervous system

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14
Q

What are the 2 reasons for SNHL when it comes to tinnitus?

A

̶- Ototoxic drugs
̶- Noise exposure/trauma

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15
Q

Noise exposure/trauma due to…

A
  • Loud recreational activities
    • Snowmobiles, water jet skis, gunfire, toys,
      fireworks, firecrackers.
      ̶- Personal music players/headphones
      ̶- Exposure to intense music (> 80 dBA)
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16
Q

What does tinnitus sound like in children?

A

Children may use a variety of terms to describe the quality of their tinnitus, such as “ringing,” “buzzing,” “humming,” “wheezing,” “peeping,” “murmuring,” “swishing,” and “whistling.

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17
Q

What are 5 common symptoms reported by children?

A

̶1) Headache
̶2) Dizziness and vertigo
̶3) Sleep disturbances
̶4) Difficulty with attention and concentration
̶5) Tiredness as a factor precipitating tinnitus

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18
Q

Parental Concerns: Tinnitus is a sign for what 3 things?

A

̶1) Hearing loss or causing hearing loss.
̶2) Mental health problems
̶3) Brain tumors or other neurological conditions

19
Q

What are 5 risk factors for tinnitus in children?

A

1) age
2) sex
3) hearing loss
4) motion sickness
5) hyperacusis

20
Q

Age - progressive increase of around ____ years.

A

13 to 14

21
Q

Sex - unlike adults, a higher prevalence of tinnitus among ____.

A

girls

22
Q

What are 3 reasons why tinnitus has a higher prevalence in girls?

A

̶1) Higher spontaneous otoacoustic emissions in female
̶2) Genetic differences
̶3) Higher tendency of girls to express symptoms.

23
Q

Hearing loss - Tinnitus incidence is around ____% in slight to mild hearing loss

A

50

24
Q

Hearing loss -̶Tinnitus incidence is around ____% in moderate to profound hearing loss.

A

23.5

25
Q

Why is tinnitus prevalence lower in those with moderate to profound hearing loss?

A
  • Communication ability to articulate the experience.
  • Cannot hear the tinnitus
26
Q

Motion Sickness - higher frequency in those with ____ and ____.

A

migraine, vestibular symptoms

27
Q

What is motion sickness?

A

Motion sickness refers to a mismatched sensory perception. It happens when the movement you see is different from what your inner ear senses. This can cause dizziness, nausea, and vomiting.

28
Q

It has been shown that ____ is the highest risk factor for tinnitus in children, but not vice versa

A

hyperacusis

29
Q

What are the 2 steps of a tinnitus evaluation

A

1) history taking
2) examinations and assessments

30
Q

History taking - ̶ open communication and caution are recommended, because:

A
  • Children are more likely to omit relevant facts.
    ̶- When questioned, they might aim to please the healthcare provider.
31
Q

History taking - 3 suggestions:

A

̶1) Conduct a child-friendly interview.
̶2) Consider cognitive and linguistic ability
̶3) Use open-ended questions

32
Q

What are 4 components of examinations and assessments for tinnitus?

A

1) Physical Examinations
2) Laboratory Tests
3) Radiological Assessments
4) Audiologic Assessments

33
Q

What are 2 components of a physical examination?

A

1) Head and neck examination (neurological evaluation)
2) Assessment of middle ear for abnormalities:
̶- Patulous Eustachian tube
̶- Myoclonic activity
̶- Carotid artery or jugular veins involvement
̶- Vascular tumors

34
Q

What are 3 components of laboratory tests?

A

̶1) Blood count, lipid profile, blood glucose screening, and virology work-up.
̶2) Screen for autoimmune disorders
̶3) Serological tests for congenital neurosyphilis

35
Q

What are 2 components of radiological assessments?

A

MRI and CT scan

36
Q

What are 4 management options for tinnitus?

A

1) medication
2) surgical intervention
3) counselling
4) relaxation and manual therapies for somatosounds

37
Q

Management options - medications

A

̶- Medications and supplements are not recommended.
̶- There is no conclusive evidence for their effectiveness.

38
Q

Management options - what 5 things might require surgical interventions for tinnitus

A
  • Persistent middle ear effusion
    ̶- Cholesteatoma
    ̶- Vascular tumors
    ̶- Myoclonic activity
    ̶- Sectioning of tensor tympani and stapedius tendons by tympanostomy.
39
Q

Management options - counselling for children (5)

A
  • Offer counseling at a child-friendly level and provide coping strategies.
    ̶- Listen to family concerns and reassuring about the nonthreatening nature of tinnitus.
    ̶- Involve the entire family in the treatment process.
    ̶- Consider hearing aids for those with hearing loss.
    ̶- Collaborate with teachers to monitor the child’s educational progress.
40
Q

Management options - counselling for youth (5)

A

̶- General counseling for developing coping strategies.
̶- Relaxation techniques (such as deep breathing exercises, and soft music) to control tension.
̶- Cognitive behavioral therapy (CBT) for those with distress and comorbid symptoms.
̶- Sound therapy using wearable or non-wearable devices.
̶- Conversations about other enjoyable aspects of life to shift focus from tinnitus.

41
Q

A ____ is required for the evaluation and management of tinnitus

A

multidisciplinary team

42
Q

Who should be on the multidisciplinary team?

A

Otolaryngologists, neurologists, physiotherapists, and dentists.

43
Q

Management options - Relaxation and Manual Therapies for Somatosounds

A
  • Relaxing Muscle Tension in Jaw and Neck
    ̶- Deactivating Myofascial Trigger Points (MTP)

Topics In Audiology (6 decks)

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