Rom J Leg Med [22] 35-40 [2014] DOI: 10.4323/rjlm.2014.35 © 2014 Romanian Society of Legal Medicine 35 Nonorganic hearing loss. Malingering, factitious or conversion disorder? Mădălina Gabriela Georgescu 1,2,* , Carmen Ioana Stan 3 , Andreea Natalia Marinescu 4 , Diana Loreta Păun 1,5 _________________________________________________________________________________________ Abstract: is paper aims to draw attention on the diagnostic of nonorganic hearing loss. It is a common diagnostic present mostly in children with apparent sudden sensorineural hearing loss and in adults who intentionally or not claim to have a hearing problem. Material and methods. Two case-reports of nonorganic hearing loss - an adult male patient who complains of leſt ear hearing loss aſter a physical aggression – head trauma in the leſt temporal region and an eight years-old boy with school problems who thought he had a hearing problem. Both patients were sent for audiological evaluation in the ENT Institute. Discrepancy between pure tone audiometry and speech test determined the audiologist to extend the audiological evaluation with objective methods – acoustic immitance, otoacoustic emissions and auditory brainstem response. Results. Objective audiological examination revealed normal hearing in the both ears in both patients. Conclusions. Uncommon informal behavior as well as discrepancies between different tests should suggest a nonorganic hearing loss which must be completely evaluated. Electrophysiologic methods are most used nowadays in these patients. Key Words: nonorganic hearing loss, malingering hearing loss, factitious hearing loss, objective audiology. 1) “Carol Davila” University of Medicine, Bucharest, Romania * Corresponding author: MD, PhD, Lecturer, Institute of Phono-Audiology and Functional ENT Surgery, Tel.: +40722544115, 21 st Mihail Cioranu street, District 5, zip code: 050751, Bucharest, Romania, Email: madalina.georgescu@otomed-center.ro 2) Institute of Phono-Audiology and Functional ENT Surgery, Audiology and Vestibulogy Dept., Bucharest, Romania 3) Ilfov County Hospital, ENT Department, Ilfov, Romania 4) Institute of Phono-Audiology and Functional ENT Surgery, Otologic Surgery Dept., Bucharest, Romania 5) “C. I. Parhon” National Institute of Endocrinology, Bucharest, Romania N onorganic hearing loss (NOHL) is a term used to describe a hearing loss that appears greater than can be explained by auditory system lesion and pathophysiology [1] and in which subjective hearing level is different from objective one. “Nonorganic hearing loss”, “pseudohypoacusis” or “functional hearing loss” is equivalent terms [2]. NOHL represents the most frequent etiology of sudden hearing loss in children [3], even though this diagnostic is oſten forgot. In literature [4] there is a recommended nomenclature with different categories of NOHL based on the degree of intent (intentional or unintentional) and type of gain (internal or external) (Table 1). NOHL in children is most frequently bilateral and is caused by a psychological / psychiatric problem - factitious or conversion disorder. In factitious, children play a sick role, in order to avoid facing school or collectivities problems. More serious are problems in conversion disorder, when children truly think they have a hearing problem as an expression of their poor