Alexandru Ionuț HRISTIAN , Manuela PĂDURARIU
ABSTRACT :
Introduction: Hearing loss in childhood, adolescence, and young adulthood is driven by mechanisms distinct from those in later life, and understanding its early-life aetiological profile is essential for guiding screening, prevention, and timely treatment. Materials and methods: This paper presents the three youngest age categories from a retrospective review of 1,275 audiological screenings and evaluations in which 648 patients received a confirmed diagnosis of hearing loss. The present cohort comprises 341 diagnosed patients aged 4-35 years, stratified into three categories: 4-14 years (n=107), 15-22 years (n=143), and 23-35 years (n=91). For each category, the distribution of conductive hearing loss (CHL) versus sensorineural hearing loss (SNHL), device-fitting status, and underlying aetiology was analysed. Results and discussion: Conductive hearing loss predominated across all three categories, accounting for 56.1% of cases in the 4-14 age group, 89.5% in the 15-22 age group, and 59.3% in the 23-35 age group — an aggregate of 242 of 341 patients (71.0%). Otitis media and other inflammatory ENT processes were the leading identifiable causes across the three categories (63%, 42%, and 33% of cases, respectively), reflecting the continued but declining role of middle-ear infection. Prolonged noise exposure from in-ear headphone use emerged as a major contributor from adolescence onward (29% and 25% of cases in the second and third categories), and ototoxic medication use rose from a marginal factor in childhood (2%) to a substantial one by early adulthood (22%). Conclusions: Hearing loss in this age range is overwhelmingly conductive and infection-driven, particularly in childhood and adolescence, with generally favourable outcomes when infection is promptly treated. However, the emergence of recreational noise exposure and ototoxic medication use as significant contributors by early adulthood foreshadows the sensorineural-dominant pattern that characterises middle and older adulthood, described in a companion paper.