During evaluation of a worker claiming total unilateral left hearing loss for compensation, a pure tone of 1000 Hz is delivered simultaneously to both ears, at 40 dB HL to the left ear and 70 dB HL to the right ear. The patient reports hearing nothing. This finding demonstrates which test principle?
- A Stenger principle, indicating non-organic hearing loss ✓
- B Tone decay, indicating retrocochlear pathology
- C Recruitment, indicating cochlear pathology
- D Binaural loudness summation, indicating normal hearing
Correct answer: A. Stenger principle, indicating non-organic hearing loss
Explanation
By the Stenger principle, when identical tones are presented simultaneously to both ears only the louder tone is perceived. A genuinely deaf left ear cannot abolish perception of the 70 dB tone in the right ear, so reporting nothing means the patient is suppressing awareness of the right ear stimulus and the loss is feigned. In true unilateral loss the patient always reports hearing the tone in the better ear.
Reference: Dhingra's Diseases of Ear, Nose and Throat, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.