In a Stenger test used to detect unilateral functional (non-organic) hearing loss, if the patient has genuine unilateral hearing loss in the right ear, presenting a tone at a level between the thresholds of the two ears (just above right ear threshold, just below left ear threshold) will result in the patient:

• A Not responding, as the tone is heard only in the right ear by genuine patients
• B Responding, as both ears detect the tone at this level
• C Not responding, as the tone suppresses hearing in both ears simultaneously
• D Responding, as the tone is audible in the right (better) ear ✓

Explanation

The Stenger test exploits the principle that when the same tone is presented simultaneously to both ears, only the louder signal is perceived (Stenger effect). In a patient with genuine right-sided hearing loss, a tone presented between the two ear thresholds is heard only in the better (left) ear — the patient responds. In a malingerer claiming right-sided loss but with normal hearing, the louder signal in the right ear dominates and the patient (not wanting to acknowledge hearing) fails to respond — a positive Stenger test indicating non-organic 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.