Non Organic Hearing Loss

Question 1

Define NOHL

Answer 1

Patients reporting hearing loss with no evidence of anatomical or physiological disorder
Feigning or exaggerating a hearing loss whether conscious or deliberate

Question 2

Why do some people present with a NOHL?

Answer 2

Financial gain/attention seeking or psychogenic where they are unaware they are simulating a hearing loss

Question 3

What objective tests can be done for suspected NOHL?

Answer 3

Tympanometry
Acoustic reflexes
Transient OAEs
ABR (evoked)

Question 4

What subjective tests can be done with suspected NOHL?

Answer 4

Lombard test (bilateral)
Stronger test (unilateral)

Question 5

What is the Lombard test?

Answer 5

Masking noise is raised while patient reads out a random text - if they speak louder as the masking is raised this could be a sign that the can hear

Question 6

What is the Stenger check?

Answer 6

Unilateral test where 2 tones of similar frequencies are played