Smith Harriet, Fackrell Kathryn, Kennedy Veronica, Barry Johanna, Partridge Lucy, Hoare Derek J
NIHR Nottingham Biomedical Research Centre, Ropewalk House, 113 the Ropewalk, Nottingham, NG1 5DU, UK; Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK.
Bolton NHS Foundation Trust, Halliwell Health and Children's Centre, Bolton, BL1 3SQ, UK.
Int J Pediatr Otorhinolaryngol. 2019 Jul;122:141-151. doi: 10.1016/j.ijporl.2019.04.006. Epub 2019 Apr 11.
The reported prevalence of tinnitus in children is similar to that in adults. However, unlike adults, there is relatively little understanding of the tinnitus-related problems children experience. Knowledge of the problems experienced by adults has led to the development of numerous clinical questionnaires used by health professionals in assessment and treatment practices; to date no child-specific questionnaire measure of tinnitus has been developed. To support development of a questionnaire measure of tinnitus in children, the aim of this scoping review was to catalogue the peer-reviewed and grey scientific literature according to 1) the methods used to identify problems experienced by children with tinnitus, 2) tinnitus-related problems observed in or reported by children, and 3) research recommendations suggested by investigators with regards to tinnitus in children.
A scoping review was conducted following an established methodological framework. Records were included where a tinnitus-related problem was reported in a child 18 years or younger, and tinnitus was reported as the primary complaint. Tinnitus problems were extracted and categorised into problem themes.
Thirty-five records met the inclusion criteria for this review. Methods used to identify tinnitus-related problems in children, and the number and range of problems reported, varied across the records. Symptom impact was summarised according to six problem themes; Physical health, Cognitive health, Hearing and listening, Emotional health, Quality of life, and Feeling different/isolated. Identified research recommendations highlighted a demand for more standardised approaches.
The findings evidence the detrimental impact tinnitus can have on a child's quality of life and emotional wellbeing. The current British Society of Audiology Tinnitus in Children Practice Guidance recommends management practices to address the most broadly reported problems identified in this review; sleep difficulties, emotional difficulties, and concentration and hearing problems at school. Given the finding of this review, we suggest problems relating to the impact of tinnitus on quality of life and feelings of isolation are also important problem domains to consider when managing a child who has tinnitus. Current variability in the approach to identifying children's tinnitus problems underlines the importance of developing a standardised and dedicated measure of tinnitus in children.
报告显示儿童耳鸣的患病率与成人相似。然而,与成人不同的是,人们对儿童所经历的与耳鸣相关的问题了解相对较少。对成人所经历问题的了解促使健康专业人员在评估和治疗实践中开发了众多临床问卷;迄今为止,尚未开发出针对儿童的耳鸣专用问卷测量工具。为支持开发儿童耳鸣问卷测量工具,本范围综述的目的是根据以下内容对同行评审和灰色科学文献进行编目:1)用于识别耳鸣儿童所经历问题的方法,2)在儿童中观察到或报告的与耳鸣相关的问题,以及3)研究人员就儿童耳鸣提出的研究建议。
按照既定的方法框架进行范围综述。纳入的记录需报告18岁及以下儿童存在与耳鸣相关的问题,且耳鸣被报告为主要诉求。提取耳鸣问题并将其分类为问题主题。
35条记录符合本综述的纳入标准。用于识别儿童耳鸣相关问题的方法以及报告的问题数量和范围在各记录中有所不同。症状影响根据六个问题主题进行总结;身体健康、认知健康、听力与聆听、情绪健康、生活质量以及感觉不同/孤立。确定的研究建议强调了对更标准化方法的需求。
研究结果证明耳鸣会对儿童的生活质量和情绪健康产生不利影响。当前英国听力学会儿童耳鸣实践指南推荐了管理措施,以解决本综述中最广泛报告的问题;睡眠困难、情绪问题以及学校中的注意力和听力问题。鉴于本综述的结果,我们建议在管理耳鸣儿童时,与耳鸣对生活质量和孤立感的影响相关的问题也是重要的需考虑的问题领域。目前在识别儿童耳鸣问题的方法上存在差异,这凸显了开发标准化且专门针对儿童的耳鸣测量工具的重要性。