In the Stenger test, a 1 kHz tone is presented 10 dB above the claimed threshold in the 'deaf' ear and simultaneously 10 dB below the true threshold in the good ear. A patient with functional (non-organic) unilateral deafness will:

• A Report hearing the tone in the good ear normally
• B Report hearing only in the affected ear
• C Report binaural fusion of the two tones
• D Deny hearing anything (positive Stenger — indicating functional loss) ✓

Explanation

The Stenger test exploits the Stenger principle: when the same tone is presented simultaneously to both ears, only the louder sound is perceived (the softer one is suppressed). In a patient feigning unilateral deafness, presenting the tone 10 dB above their claimed threshold in the 'deaf' ear causes that tone to dominate — the patient perceives it but, to maintain the pretense of deafness, denies hearing anything. A positive Stenger (no response) indicates functional hearing loss.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.