The Stenger test is used to detect which condition, and what principle does it use?

• A Non-organic (functional/feigned) unilateral hearing loss; Stenger's principle of binaural lateralization ✓
• B Sensorineural hearing loss; binaural summation
• C Conductive hearing loss; tuning fork comparison between bone and air
• D Cochlear versus retrocochlear lesion; difference in ABR wave latencies

Explanation

The Stenger test detects non-organic (functional/pseudohypacusis) unilateral hearing loss. It is based on the Stenger principle: when a tone is presented simultaneously to both ears, the listener perceives it only in the ear where it is louder. If the patient is feigning deafness in one ear, a tone presented at a suprathreshold level in the 'deaf' ear but at a subthreshold level in the better ear will be perceived in the 'deaf' ear — but the malingering patient will deny hearing it altogether (a positive Stenger test). A positive Stenger test strongly suggests non-organic hearing loss.

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

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Written and medically reviewed by the StethoPrep medical team.