Tests For Hearing
Which one of the following test is used to detect malinge- ring? (LQ)
Malingering/Nonorganic hearing loss (also called pseudohypacusis)
• Ocassionally patients wilfully or subconsciously exaggerate their hearing loss.
• This is functional hearing loss or pseudohypacusis or malingering
- The signs in the test behavior that suggest functional component include:
a. Inconsistent responses
b. Significant differences between the threshold obtained using ascending and descending administration of test stimuli
c. A discrepancy of > 8 dB between the SRT (speech reception threshold) and the pure tone average of 500-2000 Hz
d. Positive Stenger test
• It is used to identify unilateral or asymmetrical functional hearing loss. It is based on the concept that when both ears are stimulated simultaneously by a tone equal in frequency and phase, the auditory percept is lateralized to the ear with better hearing.
• If speech stimulus is used in Strenger test it is k/a Speech Stenger test or modified Stenger test.
• Other objective tests which can diagnose functional involvement are:
o acoustic reflexes: Pt saying hearing loss but normal acoustic reflex indicates NOHL
o auditory brainstem response
o otoacoustic emission
Other tuning fork tests which can be used to detect malingering but are now outdated are:
• Teel's test
• Lombard's test
• Cham in i-Moos test
• Gault test