Is imaging necessary in pediatric patients with isolated tinnitus?
Abstract
OBJECTIVES: Tinnitus is a common otologic complaint which can range from bothersome to debilitating. Imaging is frequently utilized to rule out tumors, fractures, and other causes but can also cause significant medical and economic burden for patients. Furthermore, the pediatric population may require sedation for imaging. This study explored how commonly imaging was performed in pediatric patients with isolated tinnitus and whether imaging results affected clinical care.
METHODS: A retrospective case series of 266 patients aged 0-22 years diagnosed with tinnitus at a tertiary children's hospital was performed. Patients with otologic complaints other than tinnitus were excluded. Logistic regression, Wilcoxon rank-sum tests, and log-rank survival analysis were used for statistical analysis.
RESULTS: The mean age of tinnitus diagnosis was 13.4 years (IQR 10.8-16.7), 221/266 (83.1 %) of patients were white, and 139/266 (52.3 %) were male. In the 108 with details available, 29 (26.9 %) had pulsatile tinnitus. Twenty-one of two-hundred and sixty-six (7.9 %) had a history of migraines and 24/266 (9.0 %) had a history of psychiatric diagnosis. Seventy-four out of two-hundred and sixty-six (27.8 %) of patients completed CT and/or MRI imaging. Eleven out of forty-four (14.9 %) of those who underwent imaging had abnormal findings, and only 1 MRI and 1 CT showed new abnormal findings. Of note, the abnormal MRI and CT were of the same patient, and the CT was obtained as part of a trauma…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 266 participants or records.
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