A 55 year old right handed man presented to the ear, nose, and throat outpatient clinic with tinnitus and reduced hearing in his right ear. Clinical examination was unremarkable. His pure tone audiogram showed an asymmetrical sensorineural hearing loss, worse on the right, with a decrease on that side at 4-6 kHz (fig 1⇓) typical of a noise induced hearing loss.1 He had been playing golf with a King Cobra LD titanium club three times a week for 18 months and commented that the noise of the club hitting the ball was “like a gun going off.” It had become so unpleasant that he had been forced to discard the club.

Magnetic resonance imaging of his internal acoustic meati showed no abnormality, and we deduced that his asymmetrical sensorineural hearing loss was attributable to the noise of the golf club. Other than regular …