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Stenger test, pure tone

CPT4 code

Name of the Procedure:

Stenger Test, Pure Tone

Summary

The Stenger test is a simple audiological evaluation used to detect cases of unilateral hearing loss (hearing loss in one ear) that may be feigned or exaggerated.

Purpose

The primary purpose of the Stenger test is to identify individuals who might be pretending to have hearing loss in one ear. It helps to differentiate between true hearing impairment and non-organic (psychogenic or functional) hearing loss. The goal is to ensure accurate diagnosis and appropriate treatment planning.

Indications

  • Complaints of hearing loss in one ear.
  • Suspected non-organic hearing loss.
  • Inconsistent results from standard hearing tests.
  • Patients claiming asymmetrical hearing loss during assessments.

Preparation

  • No special preparation is necessary.
  • Patients should bring any existing hearing test results.
  • Removal of any hearing aids or ear protection.

Procedure Description

  1. The audiologist will conduct the test using an audiometer, which produces pure tones at varying frequencies and intensities.
  2. The patient is asked to indicate when they can hear a tone in either ear.
  3. The audiologist will present a tone to both ears simultaneously. One tone will be played at a level just below the patient’s threshold of hearing (cannot be heard) in the non-responsive ear (reported as impaired) and at a significantly louder level in the responsive ear (reported as normal or near normal).
  4. If the patient claims not to hear the louder tone, it suggests malingering or exaggeration of the hearing loss.

Duration

The Stenger test typically takes about 5-10 minutes to complete.

Setting

The procedure is usually performed in an audiology clinic or a specialized outpatient hearing center.

Personnel

  • Audiologist
  • Trained audiology technician (if necessary)

Risks and Complications

  • No significant risks or complications are associated with the Stenger test.
  • Rarely, the test may cause temporary discomfort due to the loud tones.

Benefits

  • Provides clarity in cases of suspected non-organic hearing loss.
  • Helps in developing accurate treatment plans.
  • Ensures proper allocation of medical resources by identifying true cases of hearing impairment.

Recovery

  • No recovery time needed.
  • Patients can resume normal activities immediately after the test.
  • Follow-up appointments may be scheduled based on the results.

Alternatives

  • Other audiological tests like the Speech Stenger Test or pure tone audiometry.
  • Medical imaging (e.g., MRI) to rule out other causes of unilateral hearing loss.
  • Regular monitoring and retesting if non-organic hearing loss is suspected.

Patient Experience

  • The patient will sit comfortably and listen to varying tones through headphones.
  • The test is non-invasive and involves no physical discomfort.
  • Patients should expect a brief and straightforward examination process.