This my AN journey, I was 48 when this started, it might answer some of your questions.
Woke up one morning in July 2007 and could not hear anything in my left ear, had perfect hearing the day before. Went to a ENT, she put me on steroids and ordered an MRI to, in her words, "rule out the slim chance something else is going on". Go back two weeks later to see the ENT, no improvement in my left side hearing, right side was perfect the entire time. She starts telling me I have acoustic neuroma, a non cancerous brain tumor that can cause sudden hearing lose. I asked her if my wife should be hearing all this, she said yes, I will go get her. They come back in and the ENT is telling me how rare it is to have this tumor, she then says you have one on the right side as well which is extremely rare. The twins were both 1cm. She referred me to Dr. Eisenman at the University of Maryland Medical Center
At this point I researched my rear end off and found this site, I also realized I was in serious trouble and at the very least I would be permanently deaf in my left ear.
I consulted with Dr. Eisenman, he recommended surgery to remove the left one since the damage was already done. He wanted to preserve the hearing nerve for a cochlear implant down the road if needed, we did not have a plan for the right one at that point in time. We scheduled the surgery for November 2007.
A couple days before the surgery for the left side, the hearing in my right ear went down to a point my wife had to call Dr. Eisenman because I couldn't hear. Now the plan changed a little bit, we still did the surgery on the left side as planned. It was the middle fossa and I was on the table for 12 hours. The plan was to keep me in the hospital and do the second surgery a week later. I recovered so well they sent me home, I came back eight days later for the right side surgery. The right side surgery was the middle fossa decompression you are asking about, I was on the table for 8 hours for this one. When my Dr. explained this to me it is basically how you described it. He did mention it is much easier the actually removing the tumor and the facial nerve is never in harms way. Other then the ringing in both ears the only other problem was my left eye wouldn't blink for about two weeks.
This is where I'm at today.......I have balance problems and ringing in both ears, I get annual MRIs and the right side tumor is still there but is stable and has not grown. Saw my Dr. in December and I asked him what would we do if this tumor has to be attended to, he is recommending surgery, I was a little surprised at that...............hope it never comes to that.
Oh, about a year ago I got Phonak Bicros hearing aids, let me tell you these things are fantastic, I can actually hear sounds on my left/deaf side, phone converstaions as well.
Hope this helps