Hi seavol .....
Many of us traveled great distances to have the best treatment possible. However, this is an individual decision, based on many things.
I, for one, decided I wanted to increase my chances for a successful outcome and flew across the US for my surgery in LA. For me, it was the best decision and I had a very successful outcome.
As for hearing loss, it all depends upon which direction your AN is growing in the internal auditory canal. If it is close to the cochlea end, your hearing will be affected sooner. If it is growing toward the brainstem, you may not have any hearing loss for quite awhile. And, of course, any variation between. Symptoms (not necessarily size) often dictate how quickly a patient seeks treatment.
When I was originally diagnosed, my AN ear hearing was approximately 80% of normal, with 100% speech discrimination. Following my first surgery, it was 20% but still 100% speech discrimination so I effectively used a regular, air-conducted hearing aid until my second surgery, which took the remaining hearing. I have a bone-conducted hearing assist (Oticon Medical Ponto Pro) now which is a big boost to hearing things from my AN side.
Remember ..... none of us are medical professionals on this forum, but we can share much of our personal research and experiences.
Thoughts and prayers.
Clarice