Red flags & when to go in person for Ringing in Ears (Tinnitus) in Children

Audience: pediatric

Tinnitus, or ringing in the ears, is a common symptom that can affect children. It often feels like hearing buzzing, hissing, or ringing sounds when no external noise is present. While tinnitus is usually not a sign of a serious problem, it can sometimes indicate an underlying health issue. Telemedicine can help evaluate mild cases and provide guidance, but certain symptoms require in-person care. Parents should watch for red flags like sudden hearing loss, severe pain, or balance problems. Early medical attention is important to identify causes and prevent complications. This guide helps families understand when to use telemedicine and when to seek urgent in-person evaluation for their child’s tinnitus.

Red flags — go in person / ER

• Sudden or rapid hearing loss in the child — seek immediate in-person evaluation.
• Severe ear pain, ear discharge, or signs of ear infection with fever — visit a healthcare facility promptly.
• Dizziness, balance problems, fainting, or facial weakness/numbness accompanying tinnitus — urgent medical assessment needed.

What telemedicine can do

• Initial assessment of mild or intermittent tinnitus symptoms.
• Providing education about tinnitus and general ear care.
• Monitoring symptom changes over time with follow-up visits.
• Advising on noise avoidance and home management strategies.

What telemedicine cannot do

• Diagnosing or treating sudden hearing loss or severe ear pain.
• Evaluating neurological symptoms like facial weakness or balance problems.
• Performing physical ear examinations or hearing tests that require specialized equipment.
• Managing emergency conditions such as head trauma or infections requiring urgent care.

What is Tinnitus in Children?

Tinnitus is the perception of noise or ringing in the ears without an external sound. In children, it may be described as buzzing, hissing, or whistling sounds. It can be temporary or persistent and may affect one or both ears. Causes vary from ear infections and earwax buildup to exposure to loud noises or other medical conditions.

When Can Telemedicine Help?

Telemedicine can be useful for initial evaluation of mild tinnitus symptoms. A healthcare provider can ask about the child's history, symptom details, and any related issues. They can offer advice on managing symptoms, suggest home care, and decide if further tests or treatments are needed. Telemedicine is convenient for follow-up and monitoring.

Red Flags That Need In-Person Care

Certain signs mean your child should see a healthcare provider in person promptly:

If any of these occur, seek urgent medical evaluation.

Preparing for a Telemedicine Visit

Before the tele-visit, gather information to help the provider:

This preparation helps make the visit efficient and thorough.

After the Telemedicine Visit

Follow the healthcare provider's recommendations carefully. This may include:

Keep track of any new symptoms and communicate with your provider as advised.

How to prepare for your tele-visit

• Note the start date and pattern of the tinnitus sounds.
• Describe the type of sound (ringing, buzzing, hissing) and which ear is affected.
• List any recent illnesses, injuries, or loud noise exposures.
• Prepare a list of current medications and allergies.
• Ensure a quiet environment and a device with a working camera and microphone for the visit.

After your tele-visit

• Follow the healthcare provider’s advice on symptom management.
• Monitor for any worsening or new symptoms, especially red flags.
• Schedule follow-up telemedicine or in-person visits as recommended.
• Avoid loud noises and protect the child’s ears.
• Seek immediate in-person care if red flags appear after the tele-visit.

FAQs

What causes tinnitus in children?

Tinnitus in children can be caused by ear infections, earwax buildup, exposure to loud noises, certain medications, or other medical conditions affecting the ear or nervous system. Sometimes, no clear cause is found.

Is tinnitus dangerous for my child?

Tinnitus itself is usually not dangerous, but it can be a sign of an underlying problem. It can affect concentration and sleep. If your child has other symptoms like hearing loss or pain, it’s important to get medical care.

Can telemedicine diagnose my child’s tinnitus?

Telemedicine can help assess symptoms and guide you on next steps, but it cannot replace a physical ear exam or hearing tests that may be needed for diagnosis.

When should I take my child to see a doctor in person?

If your child has sudden hearing loss, severe ear pain, dizziness, facial weakness, or signs of infection like fever and ear discharge, you should seek in-person medical care promptly.

How can I help my child cope with tinnitus?

Encourage quiet environments, avoid loud noises, and follow your healthcare provider’s advice. Sometimes relaxation techniques and distraction can help reduce the impact of tinnitus on daily life.

Sources

1. Tinnitus — MedlinePlus, U.S. National Library of Medicine.
2. Tinnitus in Children: Causes and Treatment — American Academy of Pediatrics.
3. Tinnitus Fact Sheet — World Health Organization (WHO).
4. Tinnitus: Overview and Red Flags — Mayo Clinic.

This telemedicine guidance is for educational and triage purposes only and is not a substitute for in-person medical evaluation and care. If your child experiences any red flags or worsening symptoms, seek immediate medical attention.