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Original Investigation |

Association Between Childhood Hearing Disorders and Tinnitus in Adulthood

Lisa Aarhus, MD1; Bo Engdahl, PhD1; Kristian Tambs, PhD1; Ellen Kvestad, MD, PhD1; Howard J. Hoffman, MA2
[+] Author Affiliations
1Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway
2Epidemiology and Statistics Program, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland
JAMA Otolaryngol Head Neck Surg. 2015;141(11):983-989. doi:10.1001/jamaoto.2015.2378.
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Importance  The association between childhood hearing disorders and adult tinnitus has not been examined in longitudinal cohort studies.

Objectives  To determine the association between different types of childhood hearing loss and tinnitus in adulthood and evaluate whether tinnitus risk is mediated by adult hearing loss.

Design, Setting, and Participants  Population-based cohort study of 32 430 adults (aged 20-56 years) who underwent pure-tone audiometry and completed a tinnitus questionnaire in the Nord-Trøndelag Hearing Loss Study, which was a part of the Nord-Trøndelag Health Study 2 (HUNT2). The study was conducted from January 1, 2014, to April 1, 2015. Data analysis was performed from April 1, 2014, to April 1, 2015. As children, the same individuals had undergone screening audiometry in a longitudinal primary school hearing investigation, including ear, nose, and throat examinations when indicated.

Interventions  Pure-tone audiometry, questionnaires, and ear, nose, and throat examinations.

Main Outcomes and Measures  Self-reported tinnitus (yes or no) in adulthood measured by questionnaires.

Results  Adults who had hearing loss at the time of the school investigation (n = 3026) reported more tinnitus, measured as odds ratio (95% CI), than did adults with normal childhood hearing (n = 29 404) (1.4 [1.3-1.6]). Childhood hearing disorders associated with tinnitus in adulthood included sensorineural hearing loss, chronic suppurative otitis media, and hearing loss associated with a history of recurrent acute otitis media (2.4 [1.9-3.0], 2.4 [1.5-3.9], and 1.6 [1.3-2.0], respectively). These estimates were adjusted for age, sex, and noise exposure in adulthood. After further analyses that included adjustment for adult hearing threshold, none of these childhood hearing disorders remained positively associated with tinnitus.

Conclusions and Relevance  Childhood hearing disorders associated with tinnitus in adulthood include sensorineural hearing loss, chronic suppurative otitis media, and hearing loss associated with a history of recurrent acute otitis media. After adjustment for the adult hearing threshold, none of the childhood hearing disorders was positively associated with tinnitus. Hence, it appears that these significant associations are mediated or transmitted through adult hearing loss.

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