A 4-year-old girl with a white forelock, heterochromia iridis, and hypopigmented skin patches presents with bilateral severe-to-profound hearing loss. Tympanic membranes are normal with normal type A tympanograms. Pure tone audiometry is shown. The finding marked **D** in the audiogram—absence of air-bone gap with bone conduction thresholds overlaying air conduction thresholds—indicates which of the following?
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