Hostname: page-component-6766d58669-7fx5l Total loading time: 0 Render date: 2026-05-22T19:29:19.051Z Has data issue: false hasContentIssue false
  • English
  • Français

Efficiency of Stenger test in confirming profound, unilateral pseudohypacusis

Published online by Cambridge University Press:  08 March 2017

A Durmaz ,
S Karahatay ,
B Satar ,
H Birkent  and
Y Hidir
A Durmaz*
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, Gulhane Military Medical Academy, Ankara, Turkey
S Karahatay
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, Gulhane Military Medical Academy, Ankara, Turkey
B Satar
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, Gulhane Military Medical Academy, Ankara, Turkey
H Birkent
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, Gulhane Military Medical Academy, Ankara, Turkey
Y Hidir
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, Gulhane Military Medical Academy, Ankara, Turkey
*
Address for correspondence: Dr Abdullah Durmaz, Assistant Professor, Dept of ORL & HNS, GATA Etlik 06018, Ankara, Turkey. Fax: +90 (312) 3045700 E-mail: adurmaz@gata.edu.tr
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Conscious and deceptive exaggeration of hearing loss is termed pseudohypacusis. Even though the Stenger test has been used in the management of pseudohypacusis for almost a century, its sensitivity, specificity and predictive values for unilateral pseudohypacusis have not previously been reported, to our best knowledge. We investigated the efficiency of the Stenger test in detecting unilateral pseudohypacusis, accepting auditory brainstem response testing as the ‘gold standard’.

Materials and methods:

Candidates with questionable profound or total hearing loss were enrolled in the study. Pure tone audiometry, speech and tonal Stenger tests, and click test auditory brainstem response measurement were performed. Accepting auditory brainstem response testing as the gold standard, the sensitivity, specificity and predictive values of the Stenger test for unilateral, profound pseudohypacusis were assessed.

Results:

Two hundred military candidates were enrolled in the study. The sensitivity and specificity of the Stenger test in verifying unilateral, profound hearing loss were 99.4 and 70 per cent, respectively. The positive and negative predictive values of the test were 87.5 and 98.4 per cent, respectively.

Conclusion:

The Stenger test is widely used for the evaluation of unilateral or asymmetrical pseudohypacusis. In our opinion, it is a powerfully reliable test. More difficult cases require objective electrophysiological testing to verify functional hearing loss and to exclude specific diagnoses that may imitate pseudohypacusis.

Keywords

Sensorineural DeafnessPure Tone AudiometryAuditory Brain Stem Response

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 8 , August 2009 , pp. 840 - 844
Copyright
Copyright © JLO (1984) Limited 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

1 Rintelmann, WF, Schwan, SA, Blakley, BW. Pseudohypacusis. Otolaryngol Clin North Am 1991;24:381–90Google Scholar
2 Austen, S, Lynch, C. Non-organic hearing loss redefined: understanding, categorizing and managing non-organic behaviour. Int J Audiol 2004;43:449–57CrossRefGoogle ScholarPubMed
3 William, WQ, Fred, JS, Shengguang, SY, Louis, WW. Current evaluation of pseudohypacusis: strategies and classification. Ann Otol Rhinol Laryngol 1998;107:638–47Google Scholar
4 James, L, Hinrich, S. Nonorganic hearing loss. Semin Neurol 2006;26:321–30Google Scholar
5 Pracy, JP, Bowdler, DA. Pseudohypacusis in children. Clin Otolaryngol Allied Sci 1996;21:383–4Google Scholar
6 Radkowski, D, Cleveland, S, Friedman, EM. Childhood pseudohypacusis in patients with high risk for actual hearing loss. Laryngoscope 1998;108:1534–8Google Scholar
7 Martin, FN, Shipp, DB. The effects of sophistication on three threshold tests for subjects with simulated hearing loss. Ear Hear 1982;3:34–6Google Scholar
8 Gelfand, SA. Nonorganic hearing loss. In: Gelfand, SA, ed. Essentials of Audiology, 2nd edn. New York: Thieme, 2001;421–42Google Scholar
9 Barelli, PA, Ruder, L. Medico-legal evaluation of hearing problems. Eye Ear Nose Throat 1970;49:398–405Google Scholar
10 Gold, SR, Hunsaker, DH, Haseman, EM. Pseudohypacusis in a military population. Ear Nose Throat J 1991;70:710–12Google Scholar
11 Schlauch, RS, Arnce, KD, Olson, LM, Sanchez, S, Doyle, TN. Identification of pseudohypacusis using speech recognition thresholds. Ear Hear 1996;17:229–36Google Scholar
12 Gelfand, SA. Acoustic immittance assessment. In: Gelfand, SA, ed. Essentials of Audiology, 2nd edn. New York: Thieme, 2001;219–55Google Scholar
13 Gelfand, SA. Acoustic reflex threshold tenth percentiles and functional hearing impairment. J Am Acad Audiol 1994;5:10–16Google Scholar
14 Gelfand, SA, Silman, S. Functional components and resolved thresholds in patients with unilateral nonorganic hearing loss. Br J Audiol 1993;27:29–34CrossRefGoogle ScholarPubMed
15 Rintelmann, WF, Schvvan, SA. Pseudohypacusis. In: Rintelmann, WF, ed. Hearing Assessment, 2nd edn. Boston: Allyn and Bacon, 2001;603–52Google Scholar
16 Boyd, PJ, Rowson, VJ, Reeves, D. Application of phase-induced lateralization to the Stenger test. Audiology 1991;30:241–8Google Scholar
17 Kinstler, DB, Phelan, JG, Lavender, RW. The Stenger and Speech Stenger tests in functional hearing loss. Audiology 1972;11:187–93Google Scholar
18 Monsell, EM, Herzon, FS. Functional hearing loss presenting as sudden hearing loss: a case report. Am J Otol 1984;5:407–10Google Scholar
19 Durrant, JD, Kesterson, RK, Kamerer, DB. Evaluation of the nonorganic hearing loss suspect. Am J Otol 1997;18:361–7Google ScholarPubMed
20 Gorga, MP, Johnson, TA, Kaminski, JR, Beauchaine, KL, Garner, CA, Neely, ST. Using a combination of click- and tone burst-evoked auditory brain stem response measurements to estimate pure-tone thresholds. Ear Hear 2006;27:60–74Google Scholar
21 Sanders, JW, Lazenby, BB. Auditory brain stem response measurement in the assessment of pseudohypoacusis. Am J Otol 1983;4:292–9Google Scholar
22 Coles, RR, Mason, SM. The results of cortical electric response audiometry in medico-legal investigations. Br J Audiol 1984;18:71–8CrossRefGoogle ScholarPubMed
23 Altman, DG, Bland, JM. Diagnostic tests 1: sensitivity and specificity. BMJ 1994;308:1552Google Scholar