title: Efficiency of Stenger test in confirming profound, unilateral pseudohypacusis.
abstract: OBJECTIVE
  Conscious and deceptive exaggeration of hearing loss is termed pseudohypacusis. Even though the Stenger test has been used in the management of pseudohypacusis for almost a century, its sensitivity, specificity and predictive values for unilateral pseudohypacusis have not previously been reported, to our best knowledge. We investigated the efficiency of the Stenger test in detecting unilateral pseudohypacusis, accepting auditory brainstem response testing as the 'gold standard'.
  
  
  METHODS
  Candidates with questionable profound or total hearing loss were enrolled in the study. Pure tone audiometry, speech and tonal Stenger tests, and click test auditory brainstem response measurement were performed. Accepting auditory brainstem response testing as the gold standard, the sensitivity, specificity and predictive values of the Stenger test for unilateral, profound pseudohypacusis were assessed.
  
  
  RESULTS
  Two hundred military candidates were enrolled in the study. The sensitivity and specificity of the Stenger test in verifying unilateral, profound hearing loss were 99.4 and 70 per cent, respectively. The positive and negative predictive values of the test were 87.5 and 98.4 per cent, respectively.
  
  
  CONCLUSIONS
  The Stenger test is widely used for the evaluation of unilateral or asymmetrical pseudohypacusis. In our opinion, it is a powerfully reliable test. More difficult cases require objective electrophysiological testing to verify functional hearing loss and to exclude specific diagnoses that may imitate pseudohypacusis.
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Gulhane Military Medical Academy, Ankara, Turkey. adurmaz@gata.edu.tr
authors.forename: Abdullah
authors.initials: A
authors.lastname: Durmaz
authors.forename: S
authors.initials: S
authors.lastname: Karahatay
authors.forename: B
authors.initials: B
authors.lastname: Satar
authors.forename: H
authors.initials: H
authors.lastname: Birkent
authors.forename: Y
authors.initials: Y
authors.lastname: Hidir
mesh_terms: D000328:Adult; D001301:Audiometry, Pure-Tone / Q000379:methods* / Q000592:standards; D001309:Auditory Threshold / Q000502:physiology*; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology*; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D008297:Male; D008306:Malingering / Q000175:diagnosis* / Q000523:psychology; D008887:Military Medicine; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D014421:Turkey; D055815:Young Adult