Different Ways of Detecting Hearing Impairment in a Malingering Patient


1-JuywforQT6KC9Jn3QmZMBgThere are different ways of detecting hearing impairment in a malingering patient. If you want to know about it, read this article. You will get an idea about the kinds of problems of suspicioning malingering and hearing tests that are conducted for the purpose.

Simulation isn’t quite a frequent situation in audiology but is the most challenging subject for audiologists in Bulleen. Some patients do have the interest of simulating a hearing deficit to shirk responsibility or get financial compensation or legal suit. Simulator can even exaggerate the preexisting hypoacusis or may act to be like a deaf person although he can hear normally. Other than the financial gain, which may be involved, some of the patients have also been noticed to have some sort of psychological issue or a psychiatric problem.

In field of occupational medicine, audiological diagnosis of malingering patient may be quite useful in detecting the persons who want to hide hypoacusis, aiming acquirement of the positions which contraindicate such a pathology. An audiologist may encounter different kinds of problems of suspicioning malingering. The clues that lead an audiologist to suspecting the simulator are as follows:

The voice quality is normal in the malingerers unlike in the deaf people.
Pupillary/cochleoauricular/palpebral reflexes are conditions that exist in the patients. The reflexes cause twitching of pinna or contraction of the palperbral muscles when exposed to loud noise.
A patient with bilateral profound hypoacusis responnds to the questions that are asked with a low voice tone.
Discordance between the answers, modifications of thresholds at the various frequencies in examinations.
Ancient bilateral cophosis with little impairment of language.
Existence of discordance between the various audiometric tests. One should suspect a simulation when results at vocal audiogram are above tonal audiogram.
At vocal audiogram the patient only repeats a part of words that are presented to him whereas a person who is really dead understand a few words but in integrality.

There are different ways of detecting hearing impairment in a malingering patient. The different types of hearing tests in Bulleen, which may be used by audiologists for detecting the simulants are:

Stig Airlinger test

It consists in counting impulses that are presented for detecting the threshold. It is initiated by presenting a specific tine above a recognized threshold. The tone is randomly repeated in a number between 1–10 impulses. Patient is told to count those impulses. If patient hears sounds, the intensity is increased but if the patient says that he cannot hear, the audiologists lower the sound.

Lateralisation test

It is a very simple test that’s conducted in Bulleen to detect whether a patient is pretending to have an unilateroal cophosis or an unilateral hypoacusis. When an audiologist tests a cohotic ear with sound at 100 dB because of lateralization phenomenon, the patient hears at 30 dB with another ear allowing the really deaf person to signalize the fact that he has heard something. A malingering patient is not going to recognize that he is experiencing an acoustic sensation when testing the concerned ear.

The other hearing tests include:
Stenger test
Vocal audiometry
the carhart test
Objective audiometry tests
Otoaccustic emissions (OAE)
Brainstem evoked response audiometry (BERA)

Originally posted on : http://goo.gl/iGpqUB

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