Erhard’s & Lombard Test

Voice Tests for Malingering and Non-Organic Deafness

Erhard’s Test. Erhard’s test is utilized to detect total unilateral hearing loss. In this procedure, the ear canal of the normal ear is occluded, which reduces speech perception by 30 dB or less. The suspected malingerer is instructed to close their eyes and repeat words they hear. The examiner occludes the normal ear by pressing on the tragus and then speaks words into the suspected ear. If the patient fails to repeat the words, it suggests malingering, as even with the head shadow effect, the other ear should still be able to hear.

Lombard’s Test. Lombard’s test is grounded in the observation that individuals typically raise their voice when speaking in noisy environments. During this test, the patient is asked to read prose aloud. Noise is then introduced to the good ear. If there is an organic loss in the suspected ear, the patient will raise their voice. Conversely, if the hearing loss is feigned, the patient will show no change in speech volume, indicating normal monitoring of their voice.

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Reference Textbooks.

• Scott-Brown, Textbook of Otorhinolaryngology-Head and Neck Surgery.
• Glasscock-Shambaugh, Textbook of Surgery of the Ear.
• P L Dhingra, Textbook of Diseases of Ear, Nose and Throat.
• 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
• Hans Behrbohm, Textbook of Ear, Nose, and Throat Diseases With Head and Neck Surgery.
• Salah Mansour, Middle Ear Diseases – Advances in Diagnosis and Management.
• Logan Turner, Textbook of Diseases of The Nose, Throat and Ear Head And Neck Surgery.
• Rob and smith, Textbook of Operative surgery.
• Anirban Biswas, Textbook of Clinical Audio-vestibulometry.
• Arnold, U. Ganzer, Textbook of  Otorhinolaryngology, Head and Neck Surgery.

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