How to perform the Stenger test with Equinox Evo

12 March 2025

10 mins

Reading

Required equipment

Equinox Evo
A patient response button
Calibrated headphones or insert phones

Test procedure for tone Stenger

Open the AC440 module.

Choose settings for Stenger using the input and output for channel 1 and channel 2 as illustrated below (Figure 1).

**Figure 1:** Man (Manual) and if preferred Multi Pulse should be selected for channel 1, and Sim (Simultaneous) for channel 2.

Typically, the instruction to the patient is not different than with normal pure tone audiometry. The patient does not need to be informed that stimuli are presented at both ears simultaneously.

Use channel 1 for the poorer ear and set the intensity level 10 dB below the claimed threshold.

Use channel 2 for presenting tones to the better ear and set the intensity level 10 dB above the threshold.

Present the tones to both ears simultaneously. Keep the intensity level of the better ear fixed and increase the intensity for the poorer ear in 5-dB steps.

If the hearing loss in the poorer ear is genuine, the patient will keep responding to the signal, as it is perceived in the better ear (negative Stenger). In case of a non-organic hearing loss, the patient will stop responding when the level exceeds the claimed threshold of the poorer ear (positive Stenger).

Test procedure for speech Stenger

Open the AC440 module and go to the speech screen.

Choose settings for Stenger using the input and output for channel 1 and channel 2 as illustrated below (Figure 2).

**Figure 2:** Rev (Reverse) and if preferred Multi Pulse should be selected for channel 1 and Rev (Reverse) or Sim (Simultaneous) for channel 2.

Clarify the test procedure for the patient. Explain that they will now hear speech, and the assignment is to repeat the presented words or numbers.

Use channel 1 for the poorer ear and set the intensity level 10 dB below the claimed threshold.

Use channel 2 for presenting speech to the better ear and set the intensity level to 10 dB above the threshold.

Present the speech material to both ears simultaneously. Keep the intensity level of the better ear fixed and increase the intensity for the worse ear in 5-dB steps.

If the hearing loss in the worse ear is genuine, the patient will keep repeating correctly to the speech signal presented to the better ear (negative Stenger). In case of a non-organic hearing loss, the patient will stop responding when the level exceeds the claimed threshold of the poorer ear (positive Stenger).