I, for one, don't think they mean a thing inside the fraternity either.
Everytime I hear someone being specially introduced as his most worshipful grand illustrious distinguished omnipotent poobah, about 5 minutes after being told we meet on the level, I can't help but think of Animal Farm.
"All animals are equal, but some animals are more equal than others"
Proper masonic etiquette demands it. Not the individual who holds the title.
The brother that stands up and insists that you shouldn't call him by his proper title after doing so and points out "because we're all on the level," in front of everyone is just as stressful as the brother who points out his title isn't being used properly.
Do not belittle the person who is doing introductions. That is their job.
Now, will I get upset if I'm not introduced? No. Am I going to point that out to the senior deacon? No.
I do not care if people call me worshipful brother. However, I'm not going to go out of my way to make that known. Doing so, IMO, is a passive aggressive attempt at throwing your title in their face to draw attention to it.