When you see the specialist, please don’t bluff. Ask for a thorough explanation of what’s going on and why they are recommending this, that, or the other thing. Please ask them to explain your audiogram so you understand what it says.
You have a very small sensorineural loss at most frequencies. That’s shown by the lines connecting the [ and ] bracket signs on your audiogram. If that loss were all you had to deal with you probably wouldn’t even notice it. The bracket signs show a big dip in sensorineural hearing at 2K – that’s the Carhart’s Notch Um Bongo mentioned. All I know about that is that when I had stapes surgery my hearing at 2K improved much more than the original audiogram had predicted. So I wouldn’t worry about that right now.
As I understand it a cochlear implant is only for people with profound sensorineural loss. That’s not you. I would forget about CI.
Your problem is that you have a large conductive loss. A BAHA addresses conductive loss, but I wouldn’t jump to the conclusion that you need that. A BAHA is usually used for patients who have lost all of their hearing in one ear but have good hearing in the other ear. Stapes surgery is also a solution for conductive loss. Um Bongo says the Carhart’s notch (that big dip at 2,000 Hz shown in the upper part of your audiogram) is an indicator for otosclerosis, which would be fixed by stapes surgery.
When we hear a sound, the sound waves enter the ear canal and vibrate the eardrum. As the eardrum vibrates, it strikes a tiny bone in the middle ear, which sets two more tiny bones vibrating. The last of those bones is the stapes bone. The stapes vibrates against the cochlea, which contains many sensory cells designed to respond to specific frequencies. Those cells send signals to the auditory nerve, which sends the information to the brain. The brain then interprets what we’ve heard.
If something goes wrong with the eardrum or the three bones in the middle ear, that causes a “conductive” loss. It’s a mechanical problem, basically. For instance, if there’s a big hole in the eardrum, the eardrum can’t vibrate to set the whole hearing process in motion. If the middle ear is full of pus from a bad ear infection, that can dampen the eardurm’s vibrations and interfere with the vibration of the bones. In otosclerosis, extra bone gets deposited which fuses the bones in the middle ear together and it can fuse the stapes bone to the cochlea. That prevents the bones from vibrating as they should. I hope the specialist you’re going to see will explain exactly what the problem in your ears is.
“Sensorineural” hearing loss is a problem in the cochlea or the auditory nerve. Usually it’s a problem in the cohclea, and in older people it’s often simply a case of the sensory cells dying off. In older people, it’s the cells that perceive high frequencies (high-pitched sounds such as birds, squeaky things, and unfortunately many consonants) that tend to die.
When they do an audiology test, one part of the test sends sounds through the air. Those sounds have to go the whole distance – to the ear drum, then the bones of the middle ear, then the cochlea, then the nerve. The results are called “air conduction.” Then they strap a device tightly to your skull and test again. The device sends sounds directly to the bone near your cochlea. It bypasses the eardrum and the middle ear. Those results measure “bone conduction.”
If someone has good bone conduction results but poor air conduction results, they’re said to have a conductive loss. That describes your situation. It indicates there’s something going wrong before the sound ever reaches the cochlea or the nerve.
I had otosclerosis in my left ear in addition to moderate/severe sensorineural loss in both ears. I became almost deaf in my left ear. Two years ago I had stapes surgery (stapedotomy) in that ear. The surgery replaced part of the stapes bone with a piece of titanium and restored the ability of the bone to send vibrations to the cochlea. The results were wonderful. I still need hearing aids because of my sensorineural loss, but now my hearing is about equal in each ear, and my loss is in the range that is easily corrected with hearing aids. It’s an outpatient surgery which takes about an hour. Medicare covers it.
Another member of this forum had stapes surgery recently. His name is Squerly. If the specialist recommends stapes surgery, you could look at his posts to learn more.
Good luck at your appointment!
Edit: I had the surgery last year, not two years ago.