<s>[INST] Hello doctor, I got a piston in the right ear 30 years ago. I am 58 years old and 84 kg weight. I feel hard to hear now. I have attached my recent audiogram result details for your reference. [/INST] Hi. From the available information, it seems to me that you might have a condition called otosclerosis. Otosclerosis is a condition in which there is abnormal bone growth in the ear which prevents the sound vibrations from being conducted adequately from the external ear to the inner ear.  This can be confirmed with a test known as a tympanogram. Once it is confirmed, you might have to undergo a revision surgery which is done by a surgeon. In most cases, it improves the hearing considerably. If it does not improve with this, you might have to opt for a hearing aid. For further information consult an audiologist online --> </s>