Otosclerosis - when is surgery a good plan?

I've been having considerable problems understanding people.   I honestly thought it was people talking low or mumbling (for a long time)  Anyway, I had some audio tests done (At hearing aid outfits) and the outcome was that I ended up with a hearing aid (surprise)  Thats several years ago.   It doesn't seem to help much so I've stopped wearing it.   I have the same amount of problems hearing.   They had a "free" ear check at a local hearing aid place and I went in with the intent of NOT buying anything.   I was quite surprised when the technician told me that it would be improper to try and sell me one.   He sent me to go talk to an ENT with a copy of the audiogram.  It apparently shows the classic 2k dip which (I'm told) indicates I have Otosclerosis.  I had another round of audio tests (Same thing) at the doctors and the results were the same.  The ENT said that I had 20 something DB loss and he didn't want to rush me into surgery.   He said this depended a lot on how much trouble I have hearing.

So - sorry for the long intro but how bad does it have to be to get a chance at fixing this issue with surgery?   Is it up to me or are doctors going by some sort of amount of loss thing.  

One other question.   I have problems hearing out of either ear.   One is worse then the other.  It appears form the Audiogram that I have this "Bone conduction loss / Carharts notch" dip at 2k in both ears.  Do they do both ears?   I know they wouldn't do both at the same time (Like Knee replacement) but I'm wondering if the eventual plan is both ears to inprove hearing or just one?

What criteria for treatment and if anyone has any suggestions on how to choose the surgeon would be greatly appreciated!

[Paderla Anitha, DNB]

Hello and hope you are doing well.

Otosclerosis usually affects bilaterally. Indications for surgical management of otosclerosis include conductive hearing loss with a greater than 20 dB air-bone gap. Hearing aids are helpful below this level. And patients should have the ability to tolerate the procedure in supine position. Each ear is operated on separately.

Hope this helped and do keep us posted.

[JamesC186282]

Thanks Dr Anitha.  I looked at the notes and it was 20dB of loss so thats right at the cusp.   If I can ask another question?   How much hearing improvement can you expert (Typically) and is does this work long term or?   - Thanks

[Paderla Anitha, DNB]

Hello and hope you are doing well.

Don’t worry the prognosis is very good with this surgery. Stapedial surgery is able to obtain excellent hearing results in the long-term in most otosclerotic patients. It does restore hearing, though there may not be a complete correction of the hearing loss. Discuss this with your doctor, based on which you can decide.

Hope this helped and do keep us posted.

[JamesC186282]

I thought I would post a short update for anyone reading this.   The ability to understand what people are saying is (I think) getting worse.  One of the people I work with asked me "When are you getting this surgery done!?"   I work with customers who all seem to whisper.   I think I've learned how to read lips pretty well because they are much less understandable when I can't see their lips move.  ;-)

Which I think is some sort of hint that they (at least) would like it fixed.   My insurance plan is rather difficult to understand but the costs can still have a considerable out of pocket cost.  I'm currently trying to figure out what it will cost and any ways I can reduce them.