A Descending Lot-Bekesy Screening Test for Functional Hearing Loss

Abstract

This study investigated the screening efficiency of a descending version of Hattler's Lengthened Off-time (LOT) Bekesy test. The Descending LOT (DELOT) test was administered to 24 subjects who presented unequivocal audiometric evidence of functional hearing loss during clinical examinations and 30 subjects with no audiometric evidence of functional loss. The DELOT format substantially increased screening sensitivity: 29.2% more functional group subjects and 42.2% more functional group ears were identified correctly relative to LOT test identifications. There was one marginally positive DELOT outcome involving one ear in the nonfunctional group. The high sensitivity of the DELOT test was clearly a function of significantly larger intertrace gaps caused by the DELOT trace. The mean intertrace gap for the DELOT test was more than 10 dB greater than the gap for the LOT test.

Effective Identification of Functional Hearing Loss Using Behavioral Threshold Measures

“…The stimulus duration was 200 ms with an 800-ms off-time for descending runs. Chaiklin (1990) found that a lengthened off-time (20% vs. 50% duty cycle) for descending runs increased the threshold gaps of persons presenting with functional hearing loss. The starting level for each threshold search was 90 dB HL.…”

“…Persons feigning a loss show a significant discrepancy, whereas persons not feigning a loss show excellent agreement for thresholds obtained using the ascending and descending approaches (Chaiklin, 1990;Harris, 1958;Schlauch et al, 1996). This ascending-descending approach has been used successfully to maximize pure-tone threshold differences (Chaiklin, 1990;Harris, 1958) and ST-PTA differences in persons presenting with functional hearing loss (Schlauch et al, 1996). Important considerations for evaluating the effectiveness of a test for functional hearing loss are its true-positive rate and its false-positive rate.…”

“…The finding that most persons feigning a hearing loss adopt an internal loudness reference has been used as the basis for some tests for identifying functional hearing loss (Chaiklin, 1990;Harris, 1958;Schlauch et al, 1996). These tests use a discrepancy between "thresholds" (loudness judgments in persons feigning a loss) obtained for ascending (e.g., starting level -10 dB HL) and descending (e.g., starting level 90 dB HL) series.…”

Current Evaluation of Pseudohypacusis: Strategies and Classification

“…Standard audiologic evaluations may include audiometry, tympanometry, and the acoustic reflex (AR). Other tests reported in the literature to aid in diagnosis have included the Bekesy test, 8 the Lombard test, and delayed auditory feedback." The Stenger test is widely applied for evaluation of unilateral or asymmetric pseudohypacusis.?…”

Validation of multi-channel auditory steady-state response in adults with sensorineural hearing loss

“…Standard audiological evaluation may include audiometry, tympanometry and acoustic reflex testing. Other diagnostic tests reported in the literature include the Bekesy test, 7 Lombard test and delayed auditory feedback 8 . The Stenger test is widely used to evaluate unilateral or asymmetrical pseudohypacusis 2 .…”