Erhard’s & Lombard Test - Voice tests for malingering

VOICE TESTS FOR MALINGERING / NON- ORGANIC DEAFNESS

Erhard’s Test: Detects total unilateral hearing loss. In this test, the meatus of the normal ear is occluded. This attenuates speech by 30dB or less. The suspected malingerer is asked to close his eyes and repeat words heard. He is told that the normal meatus is being occluded and the examiner closes it by pressing the tragus. Words are then spoken in the suspected ear, failure to repeat the words indicates malingering since even with head shadow effect the other ear should be able to hear.
Lombard’s Test: Based on the principle that an individual raises his voice when speaking in a noisy surrounding. The patient is asked to read prose. Noise is then applied to the good ear. If there is organic loss in the suspected ear then the voice level is raised, if feigned then normal monitoring is unimpaired and there is no change in speech.

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Learning resources.

Scott-Brown, Textbook of Otorhinolaryngology Head and Neck Surgery.
Glasscock-Shambaugh, Textbook of Surgery of the Ear.
Hazarika P, Textbook of Ear Nose Throat And Head Neck Surgery Clinical Practical.
Mohan Bansal, Textbook of Diseases of Ear, Nose and Throat Head and Neck surgery.
Anirban Biswas, Textbook of Clinical Audio-vestibulometry.

Author:

Dr. Rahul Kumar Bagla
MS & Fellow Rhinoplasty & Facial Plastic Surgery.
Associate Professor
GIMS, Greater Noida, India
msrahulbagla@gmail.com