The Stenger test is based on the auditory phenomenon “The Stenger Principle” and is used when a patient is suspected malingering a hearing loss. The Stenger Principle states that only the louder of two similar tones presented to both ears at the same time will be perceived. Generally, it is recommended only to perform the Stenger test in cases of unilateral hearing losses or significant asymmetries (at least 20dB).
The speech Stenger test is identical, but with the use of speech material instead.
If the hearing loss in the worse ear is genuine, the patient will keep responding to the signal presented to the better ear (negative Stenger).
If the patient is simulating the hearing impairment, he will not respond to the stimuli, which shows that the tone presented in the poorer ear is better than what the individual indicates (positive Stenger).