Mixed Hearing Loss in the Pediatric Population: Etiology, Evolution, and Management

Mixed hearing loss (MHL), defined by the coexistence of conductive and sensorineural hearing loss (HL), is a poorly investigated condition in children. This study aimed to describe the clinical characteristics, etiological spectrum, and audiological evolution of pediatric MHL. We retrospectively reviewed medical records of children aged 5–18 years with MHL, evaluated between January 1, 2017, and July 30, 2025, at the Audiology Clinic of the Policlinico of Milan (Italy). A total of 16 800 pure-tone audiometric examinations were analyzed, and demographic, clinical, audiometric (baseline and 1-year follow-up), radiological, and genetic data were collected. The study revealed that pediatric MHL has a heterogeneous, predominantly syndromic and genetic etiology, often associated with otologic malformations or OM. Audiological outcomes vary, underscoring the need for individualized management and long-term follow-up, regardless of UNHS results.