Special Tuning Fork Tests for Malingering and Non-Organic Deafness
1. Stenger’s Test. Stenger’s test is based on the principle that when two identical sounds are presented to a person with one healthy ear and one deaf ear, the individual will only perceive the sound in the ear that is closer to the sound source.
Procedure: In this test, the patient is blindfolded. The examiner uses two similar tuning forks, typically of 512 Hz, struck to moderate intensity and held approximately 25 cm from each ear. If the patient is malingering, he will only hear the sound in the normal ear. The tuning fork on the deaf side is then moved closer by 3 inches. A malingerer will not perceive the sound at all, confirming the suspicion of non-organic deafness.
2. Chimani Moos Test. The Chimani Moos test is a modification of the Weber test, designed to identify non-organic hearing loss.
Procedure: When a vibrating tuning fork is placed on the forehead, a malingerer will often report hearing the sound in their better ear, which simulates sensorineural deafness. If the ear canal of the better ear is occluded, a genuinely deaf patient will still hear the sound in the occluded ear, while a malingerer will claim they cannot hear it.
3. Teal Test. The Teal test is specifically used for patients who assert that they can only hear through bone conduction. This test evaluates the validity of such claims.
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Stenger’s, Chimani Moos, Teal Test Lecture Notes Dr Rahul Bagla ENT Textbook
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.
Author:
Dr. Rahul Bagla
MBBS (MAMC, Delhi) MS ENT (UCMS, Delhi)
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