Stenger test | PGI Based MCQ

Stenger test is used to detect:

A. Conductive hearing loss
B. Sensorineural hearing loss
C. Mixed hearing loss
D. functional hearing loss
E. malingering

The Answer is.D. functional hearing loss, E. malingering

Stenger test, teal test and Lombard test are used to detect functional hearing loss.

Stengertest : a test for detecting simulation of unilateral hearing impairment, in which a tone below the admitted threshold is presented to the test ear and a tone of lesser intensity is presented to the other ear. If the subject is feigning a hearing loss, the lesser tone cannot be appreciated.

Tests for malingering:

ChimaniMooss test:  This is nothing but a variation of Weber's test.  Normally in Weber's test the patient hears the best in the occluded ear.  In malingering the patient will not accept to hear better in the occluded ear.

Stenger's test:  This test is based on "Stenger's phenomenon".  In stenger's phenomenon when a listener is presented with the same type of sound in both ears he /she will heara single sound, that too only in the ear which it is louder.

Procedure:  Two tuning forks with frequency of 512 Hz are kept equidistantly from both ears, one should be able to hear equally well in either side.  In malingering say i.e. left ear, even if the tuning fork is moved too close to the left ear, the patient denies that he is hearing in the right side also.

Teal's test:  In this test a vibrating tuning fork is applied over the mastoid process of the so called deaf ear, the patient accepts to hear it.  Then the patient is blind folded and with a non vibrating fork on the mastoid process, the malingering patient claim's to hear the sound.

Lombard's test:  This test is based on "Lombard's principle".  This principle says that one raises his / her voice when speaking in noisy environment.  While performing this test, the patient is allowed to read  a book.  Noise is introduced into the ear.  The noise is gradually increased till the patient raises his / her voice or stops the process of reading.

Erhardt's test:  This test is also known as loud voice test.  In normal person when the ear is occluded with a finger, it dampens the sound but it can still be heard.  Malingerer often denies hearing the sound even when it is loudest.

Stethoscope test:  In this test, one ear piece of the stethoscope is closed with wax and used on the side of deafness.  The funnel shaped chest piece is used to talk to the patient.

The malingerer gets confused and cannot tell whether he is hearing on the right / left side.