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What is Tinnitus?

Tinnitus is when a person hears a sound (e.g. ringing) even though nothing is causing the sound. It is the perception of sounds in the absence of external noise.

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

Types of sounds include ringing, whistling, roaring, clicking, hissing, buzzing and humming.

The sound can:

• Be constant, occasional or intermittent.
• Seem like it is coming from one side or both sides.
  

How Common Is It?

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

What Causes Tinnitus?

Tinnitus is usually a sign of inner ear damage that causes auditory processes to malfunction.

There are many possible causes for tinnitus which include the following:

• Noise exposure
• 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 - Misaligned jaw joints
• Neck or head trauma, such as concussion
• Menière’s disease
• Vestibular schwannoma

Signs and Symptoms of Tinnitus

For many people, the sounds may not cause any distress. Especially if a person is young, they may not know that others cannot hear the sound and may not think about telling you.

For other people, the sounds can be distressing and cause problems such as:

• Sensitivity to noise. The person might get distressed in a noisy environment, or they try to avoid noisy situations.
• Quiet avoidance. Some people might be the opposite and have more difficulties in quiet environments.
• Difficulty paying attention or listening to others, unexplained listening difficulties.
• Poor academic performance.
• Difficulties with sleep. In some cases, people might want background noise to fall asleep; or may not want to fall asleep or need a quiet bedroom.
• Irritability, tantrums.
• Fatigue.
• Anxiety or depression.

Are you noticing any of the above symptoms in a loved one or a child?

• If so, ask them if they hear sounds in their ears or head.

Self-Help Strategies for Tinnitus

There are many ways to help tinnitus:

• Reduce exposure to loud noise, e.g. move away from loud noise, turn down the volume, wear hearing protection.

• Live a healthy lifestyle.
  • Eating a healthy diet, getting regular physical activity outside, having good sleep hygiene can help reduce stress and tinnitus perception.
• Background noise
  • Low-level white noise: Some people find it helpful to have low-level noise from a fan, humidifier, air purifier, indoor (tabletop) water fountains, etc.
  • Low-level background music
  • White noise machines: These devices produce background noise such as static or natural sounds like rain, wind or ocean waves. Proper use of a sound machine might be helpful; however, talk to your hearing professional first.
• Are there problems with stress?
  • Consider deep breathing, relaxation or mindfulness exercises.
• Are there problems with anxiety or depression?
  • Consider seeing your primary care provider, or a mental health professional (e.g. counselor, therapist) for help.

Where to Find Help

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 such as:

• Audiologist: An audiologist can do hearing tests.
• Otolaryngologist (aka ENT or ear nose throat doctor): An ENT can assess for any treatable ear, nose or throat condition.

Treatments for Tinnitus

Is there an underlying cause for the tinnitus? If so, then treating the underlying cause may be helpful such as:

Medications

• In some cases, medications may be helpful. Note, however, that no medical treatment has 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.

Counselling, group therapy, or CBT (Cognitive Behavioral Therapy)

• Seeing a psychologist or psychotherapist can help you learn techniques to help you cope with tinnitus.

Will It Get Better?

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 you develop tinnitus after going to a concert, it might go away by itself after a few days of auditory rest. It may get better if the underlying condition is treated. In most cases, tinnitus improves as the brain becomes habituated to the sound.

For More Information

British Tinnitus Association 

https://www.tinnitus.org.uk/

Practice Guidance for children with tinnitus

http://www.thebsa.org.uk/wp-content/uploads/2015/03/2015-Paed-Tin-Guidelines-FINAL.pdf

Tinnitus information from Children's Hospital of Philadelphia

https://www.chop.edu/conditions-diseases/tinnitus

About this Document

Written by Myriam Grenier (CHEO audiology). Michael Cheng (CHEO psychiatry).

Disclaimer

This information is offered ‘as is' and is meant only to provide general information that supplements, but does not replace the information from your qualified expert or health provider. Always contact a qualified expert or health professional for further information in your specific situation or circumstance.

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